Individual provider Active NPI

Amir Gassemi, MD

  • Psychiatry Physician
  • Fayetteville, NC
National Provider Identifier
1215566294
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2025-01303 Issued in NC
Practice address
711 Executive PL FL 3
Fayetteville, NC 28305-5193
Phone
(910) 615-3333
Fax
(910) 615-3750
NPI assigned
Apr 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 2025-01303 NC Primary

Addresses

Primary practice location

711 Executive PL FL 3
Fayetteville, NC 28305-5193

Mailing address

711 Executive PL
Fayetteville, NC 28305-5193
Phone (910) 615-3333

Other practice location 1

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

Other practice location 2

7569 N West St
Falcon, NC 28342
Phone (910) 615-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251002003572 NC Practitioner - Psychiatry 5294157798 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

One Medical Ctr Blvd
Winston Salem, NC 27157-0001

One Medical Ctr Boulevard
Winston Salem, NC 27157-0001

PO Box
Charlotte, NC 28289

PO Box
Suite 40908
Fayetteville, NC 28309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025-01303NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland County Hospital System Inc CurrentSince Aug 11, 2025 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Cumberland County Hospital System Inc Psychiatry CurrentSince Aug 11, 2025 Accepting new patients

Locations

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

Interoperability endpoints

  • Direct secure messaging: agassemi137750@capefearvalley.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1215566294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 EXECUTIVE PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055193",
            "telephone_number": "910-615-3333",
            "fax_number": "910-615-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 EXECUTIVE PL FL 3",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055193",
            "telephone_number": "910-615-3333",
            "fax_number": "910-615-3750"
        }
    ],
    "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": "910-615-3750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7569 N West St",
            "address_purpose": "LOCATION",
            "city": "Falcon",
            "state": "NC",
            "postal_code": "28342",
            "country_code": "US",
            "telephone_number": "910-615-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GASSEMI",
        "first_name": "AMIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2025-01303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.