PBL Healthcare PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2009-01251 Issued in NC

Legal business name

PBL HEALTHCARE PA

Practice address

514 Beaumont Rd
Fayetteville, NC 28304-4443

Phone

(910) 485-8831

Fax

(910) 485-8832

NPI assigned

Dec 30, 2009

Organization subpart

No

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

Authorized official

Name

Bao-Anh Ngoc Bui, M.D.

Title

President/Ceo

Phone

(910) 644-2280

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1262131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262131200000",
    "number": "1194055996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 WINESAP RD",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283488357",
            "telephone_number": "910-644-2280",
            "fax_number": "910-485-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 BEAUMONT RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044443",
            "telephone_number": "910-485-8831",
            "fax_number": "910-485-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PBL HEALTHCARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-30",
        "last_updated": "2009-12-30",
        "status": "A",
        "authorized_official_last_name": "BUI",
        "authorized_official_first_name": "BAO-ANH",
        "authorized_official_middle_name": "NGOC",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "910-644-2280",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2009-01251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.