Active NPI
Agape Orthotics of NC
- Prosthetic/Orthotic Supplier
- Fayetteville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Legal business name
- AGAPE ORTHOTICS OF NC
- Practice address
- 2139 Valleygate Dr Ste 101a
Fayetteville, NC 28304-3666 - Phone
- (910) 574-9804
- NPI assigned
- May 5, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ciprian Pufulete, CPED
- Title
- Manager
- Phone
- (910) 574-9804
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Customized Equipment (DME) | 332BC3200X | |||
| Prosthetic/Orthotic Supplier | 335E00000X | Primary |
Addresses
Primary practice location
2139 Valleygate Dr Ste 101a
Fayetteville, NC 28304-3666
Mailing address
PO Box 58296
Fayetteville, NC 28305-8296
Phone (910) 574-9804
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210622000839 | NC | DME Supplier - Pedorthic Personnel | 9638570146 | Practice locations: Fayetteville, NC |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Agape Orthotics of NC | Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Surgical Dressings|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
25 Amarillo Ln
Sanford, NC 27332
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1732060800000",
"number": "1164005385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 58296",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283058296",
"telephone_number": "910-574-9804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2139 VALLEYGATE DR STE 101A",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043666",
"telephone_number": "910-574-9804"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AGAPE ORTHOTICS OF NC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-05",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A",
"authorized_official_last_name": "PUFULETE",
"authorized_official_first_name": "CIPRIAN",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "910-574-9804",
"authorized_official_credential": "CPED"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthotist",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": null,
"license": null,
"primary": false
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.