Individual provider Active NPI

Eric Isom Reisinger, PA-C

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1154629137
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2016-0097 Issued in NM
Practice address
4140 Ferncreek Dr Ste 801
Fayetteville, NC 28314-2572
Phone
(910) 484-2171
Fax
(910) 484-4568
NPI assigned
Mar 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2016-0097 NM Primary

Addresses

Primary practice location

4140 Ferncreek Dr Ste 801
Fayetteville, NC 28314-2572

Mailing address

4140 Ferncreek Dr Ste 801
Fayetteville, NC 28314-2572
Phone (910) 484-2171

Other identifiers 2

IdentifierTypeStateIssuer
1154629137MedicaidVA
541869550OtherVATRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180713002749 NC Practitioner - Physician Assistant 8224213939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2016-0097NMMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Fear Orthopaedic Clinic, PA CurrentSince Aug 10, 2020 Accepting new patients

Locations

4140 Ferncreek Dr
Ste 801
Fayetteville, NC 28314
Phone (910) 484-2171

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: eric.reisinger.p1@direct.capefearortho.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1154629137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 FERNCREEK DR STE 801",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142572",
            "telephone_number": "910-484-2171",
            "fax_number": "910-484-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 FERNCREEK DR STE 801",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142572",
            "telephone_number": "910-484-2171",
            "fax_number": "910-484-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISINGER",
        "first_name": "ERIC",
        "middle_name": "ISOM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-01",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2016-0097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154629137",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "541869550",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.