Individual provider Active NPI

Joe McKnitt Alexander Jr., M.D.

  • Ph.D. Medical Genetics
  • Fayetteville, NC
National Provider Identifier
1215044813
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ph.D. Medical GeneticsTaxonomy code 170100000X
License
33605 Issued in NC
Practice address
2911 Breezewood Ave Ste 201
Fayetteville, NC 28303
Phone
(910) 483-1811
Fax
(910) 483-6990
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X 33605 NC Primary

Addresses

Primary practice location

2911 Breezewood Ave Ste 201
Fayetteville, NC 28303

Mailing address

410 Pilot Ave
Fayetteville, NC 28303
Phone (910) 483-5618

Other identifiers 2

IdentifierTypeStateIssuer
891251AMedicaidNC
6902348MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215044813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 PILOT AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28303",
            "telephone_number": "910-483-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 BREEZEWOOD AVE STE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28303",
            "telephone_number": "910-483-1811",
            "fax_number": "910-483-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "JOE",
        "middle_name": "MCKNITT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "NC",
            "license": "33605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891251A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6902348",
            "state": "NC"
        }
    ],
    "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 Jul 8, 2007; 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.