Ave Maria Family Practice, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2009-01999 Issued in NC

Legal business name

AVE MARIA FAMILY PRACTICE, PLLC

Practice address

1230 Medical Center Dr
Wilmington, NC 28401

Phone

(910) 799-5452

Fax

(910) 799-5479

NPI assigned

Dec 1, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Dorothy Ejinkonye Agbafe-Mosley, MDNPI 1881898187

Title

Medical Director

Phone

(910) 799-5452

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Dorothy Ejinkonye Agbafe-Mosley, MD

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1881898187
  Medicare reassignment NPD Authorized official
• Valerie J Cousins, NP

  • Family Nurse Practitioner
  • Wilmington, NC
  • NPI 1932332376
  Medicare reassignment NPD
• Elizabeth Ashley Triplett, DNP

  • Family Nurse Practitioner
  • Wilmington, NC
  • NPI 1073173126
  Medicare reassignment NPD
• Michelle Robinson, LPN NCCHW

  • Community Health Worker
  • Wilmington, NC
  • NPI 1134758832
  NPD

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1215205539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16663",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284086663",
            "telephone_number": "910-799-5452",
            "fax_number": "910-799-5479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28401",
            "telephone_number": "910-799-5452",
            "fax_number": "910-799-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVE MARIA FAMILY PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "AGBAFE-MOSLEY",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "EJINKONYE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "910-799-5452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2009-01999",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "179288",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "2009-01999",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5915683",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dale Autry, PHARMACIST
• Tashayla Autry, RBT
• Autumn Corporation (Autumn Care of Myrtle Grove)
• Autumn Corporation (Autumn Care of Myrtle Grove)
• Leah Elizabeth-Maria Avant, LCSWA
• Jacob Averill, LCSW, LCAS, CCS
• Virginia Averitt, LPCA
• Danielle Marie Avery, RN/IBCLC
• Jennifer Avery, LCMHC
• Mary Eden Avery, LCSWA

• Family Medicine Physician in Wilmington, NC
• Providers in Wilmington, 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 Jul 17, 2018; 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.

Verify at the official NPI Registry.