Premier Cardiovascular Center PA

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

200500969 Issued in NC

Legal business name

PREMIER CARDIOVASCULAR CENTER PA

Practice address

1315 Avon St Ste 103
Fayetteville, NC 28304-4423

Phone

(910) 703-8718

Fax

(910) 703-8721

NPI assigned

Feb 16, 2011

Last updated

Nov 27, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kingsley Uzodinma Okoroafor, M.D.NPI 1346346889

Title

President

Phone

(910) 703-8718

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kingsley Uzo Okoroafor, MD

  • Cardiovascular Disease Physician
  • Fayetteville, NC
  • NPI 1346346889
  Medicare reassignment NPD Authorized official
• Linda Carol Tyler, FNP-C

  • Nurse Practitioner
  • Fayetteville, NC
  • NPI 1043040827
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543276800000",
    "number": "1144527763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 AVON ST STE 103",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044423",
            "telephone_number": "910-703-8718",
            "fax_number": "910-703-8721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 AVON ST STE 103",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044423",
            "telephone_number": "910-703-8718",
            "fax_number": "910-703-8721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CARDIOVASCULAR CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-16",
        "last_updated": "2018-11-27",
        "status": "A",
        "authorized_official_last_name": "OKOROAFOR",
        "authorized_official_first_name": "KINGSLEY",
        "authorized_official_middle_name": "UZODINMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-703-8718",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "200500969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.