NPIMap

Organization Active NPI

Mid Carolina Gastroenterology Associates, PA

  • Endoscopy Clinic/Center
  • Sanford, NC
National Provider Identifier
1255592002
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
License
AS0094 Issued in NC
Legal business name
MID CAROLINA GASTROENTEROLOGY ASSOCIATES, PA
Practice address
110 Dennis Dr
Sanford, NC 27330-6343
Phone
(919) 774-4511
Fax
(919) 774-3196
NPI assigned
Jun 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Authorized official

Name
Dr. Marion Butler Pate III, M.D.
Title
President
Phone
(919) 774-4511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X AS0094 NC Primary

Addresses

Primary practice location

110 Dennis Dr
Sanford, NC 27330-6343

Mailing address

110 Dennis Dr
Sanford, NC 27330-6343
Phone (919) 774-4511

Other identifiers 1

IdentifierTypeStateIssuer
34C0001125OtherNCASC IDENTIFICATION NUMBER

National Provider Directory

National Provider Directory

Locations

110 Dennis Dr
Sanford, NC 27330
Phone (919) 774-4511

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1255592002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 DENNIS DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273306343",
            "telephone_number": "919-774-4511",
            "fax_number": "919-774-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DENNIS DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273306343",
            "telephone_number": "919-774-4511",
            "fax_number": "919-774-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID CAROLINA GASTROENTEROLOGY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "PATE",
        "authorized_official_first_name": "MARION",
        "authorized_official_middle_name": "BUTLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-774-4511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NC",
            "license": "AS0094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASC IDENTIFICATION NUMBER",
            "identifier": "34C0001125",
            "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 29, 2014; 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.