NPIMap

Organization Active NPI

Central Carolina ENT Assoc PA

  • Otolaryngology Physician
  • Sanford, NC
National Provider Identifier
1205863479
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CENTRAL CAROLINA ENT ASSOC PA
Practice address
1915 KM Wicker Drive
Sanford, NC 27330
Phone
(919) 774-6829
Fax
(919) 775-2327
NPI assigned
Jun 26, 2006
Last updated
Sep 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Authorized official

Name
William C Leliever, MDNPI 1902833171
Title
President
Phone
(919) 774-6829

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X Primary

Addresses

Primary practice location

1915 KM Wicker Drive
Sanford, NC 27330

Mailing address

1915 KM Wicker Drive
Sanford, NC 27330
Phone (919) 774-6829

Other identifiers 3

IdentifierTypeStateIssuer
890107WMedicaidNC
3404108OtherNCMEDICAID - HEARING AID VENDOR
CM5921OtherNCPALMETTO GBA-RR MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1205863479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 KM WICKER DRIVE",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "27330",
            "telephone_number": "919-774-6829",
            "fax_number": "919-775-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 KM WICKER DRIVE",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "27330",
            "telephone_number": "919-774-6829",
            "fax_number": "919-775-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CAROLINA ENT ASSOC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "LELIEVER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-774-6829",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890107W",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - HEARING AID VENDOR",
            "identifier": "3404108",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RR MEDICARE",
            "identifier": "CM5921",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.