NPIMap

Organization Active NPI

Harnett Health System Inc

  • Pediatrics Physician
  • Dunn, NC
National Provider Identifier
1215077201
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HARNETT HEALTH SYSTEM INC
Practice address
802 Tilghman Dr
Dunn, NC 28334-5510
Phone
(910) 892-4248
Fax
(910) 892-4461
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Authorized official

Name
Joseph Barton Fiser
Title
VP Corp Rev Cycle/Managed Care
Phone
(910) 615-5572

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

802 Tilghman Dr
Dunn, NC 28334-5510

Mailing address

PO Box 1706
Dunn, NC 28335-1706

Other practice location 1

716 S 10th St
Lillington, NC 27546-5615
Phone (910) 892-4248

Other identifiers 2

IdentifierTypeStateIssuer
5905751MedicaidNC
018WCOtherNCBCBSNC PROVIDER #

Other names 1

  • Cape Fear Valley Pediatric Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000526 NC Part B Supplier - Clinic/Group Practice 6204748544 Receives reassigned benefits from 67 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lillington, NC

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735862400000",
    "number": "1215077201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1706",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283351706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 TILGHMAN DR",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345510",
            "telephone_number": "910-892-4248",
            "fax_number": "910-892-4461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "716 S 10th St",
            "address_purpose": "LOCATION",
            "city": "Lillington",
            "state": "NC",
            "postal_code": "275465615",
            "country_code": "US",
            "telephone_number": "910-892-4248",
            "fax_number": "910-892-4461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HARNETT HEALTH SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A",
        "authorized_official_last_name": "FISER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "BARTON",
        "authorized_official_title_or_position": "VP CORP REV CYCLE/MANAGED CARE",
        "authorized_official_telephone_number": "910-615-5572"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905751",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC PROVIDER #",
            "identifier": "018WC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cape Fear Valley Pediatric Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dunn, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.