NPIMap

Med First Immediate Care & Family Practice, PA

Organization Active NPI Family Medicine Physician · Roxboro, NC

NPI 1275201592 · NPPES record last updated Sep 1, 2021

Key facts

NPI
1275201592
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA
Practice address
107 Weeks Dr
Roxboro, NC 27573-3929
Phone
(336) 598-5480
Fax
(336) 598-5482
NPI assigned
Sep 1, 2021
Organization subpart
Yes
Parent organization (as reported)
MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA

Authorized official

Name
Jill Hughes
Title
Credentialing Specialist
Phone
(919) 341-4016

Corporate family (same tax ID) 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2239638Med First Immediate Care and Family
107 Weeks Drive, Roxboro, NC 27573		Certificate of waiverOct 12, 2027

National Provider Directory

Tax ID family
Med First Immediate Care Family Practice PA (44 organizations share this tax ID)
Part of
Med First Immediate Care Family Practice PA

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X Yes

Addresses

Primary practice location

107 Weeks Dr
Roxboro, NC 27573-3929

Mailing address

1616 E Millbrook Rd Ste 110
Raleigh, NC 27609-4971
Phone (919) 341-4016

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 1, 2021.

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1275201592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 E MILLBROOK RD STE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094971",
            "telephone_number": "919-341-4016",
            "fax_number": "910-346-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WEEKS DR",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275733929",
            "telephone_number": "336-598-5480",
            "fax_number": "336-598-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "919-341-4016"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxboro, NC

All providers in Roxboro, NC · Family Medicine Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.