MCPC-14, LLC
Organization Active NPI Internal Medicine Physician · Pinehurst, NC
NPI 1275965410 · NPPES record last updated Dec 30, 2024
Key facts
- NPI
- 1275965410
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- MCPC-14, LLC
- Practice address
- 305 Page Rd N Ste 1
Pinehurst, NC 28374-0086 - Phone
- (910) 715-8671
- Fax
- (910) 715-6878
- NPI assigned
- Jul 30, 2013
- Organization subpart
- No
Authorized official
- Name
- Mickey Foster
- Title
- Ceo
- Phone
- (910) 715-4473
Other NPIs on the same Medicare enrollment 1
Practitioners 25
-
Erin Elizabeth Morgan, PA-C
-
Suzanne Lee Wilson, M.D.
-
Daniel Ray Barnes, D.O.
-
Christine Anne McBride, PA-C
-
Cheryl B Batchelor, ANP
-
Jennifer Picerno Bowyer, FNP-C
-
Crystal Moran Coen, FNP
-
Julie Taylor Coggins, FNP
-
Darrin Gregory Cutrell, PA-C
-
Robert Leonard Deucher, M.D.
-
Julia Lynne Mabe, NP-C
-
Clare Elaine Reinhardt, M.D.
-
George Joseph Shalhoub, M.D.
-
Van Slaughter Jr., M.D.
-
Misty Hochrein Bitting, PA-C
-
Stephen S Kapa, PA
-
Rebekah B Diky, PA
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2076787 | Firsthealth Transition Care Clinic | Certificate of waiver | Apr 24, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131007000016 | NC | Part B Supplier - Clinic/Group Practice | 2567696552 |
Receives reassigned benefits from 25 practitioners 4 other NPIs on this enrollment Practice locations: Pinehurst, NC |
National Provider Directory
Locations
305 Page Rd N
Pinehurst, NC 28374
Phone (910) 295-1010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
305 Page Rd N Ste 1
Pinehurst, NC 28374-0086
Mailing address
305 Page Rd N Ste 1
Pinehurst, NC 28374-0086
Phone (910) 715-8671
Other names
- FIRSTHEALTH TRANSITION CARE CLINIC
NPI Registry JSON
{
"created_epoch": "1375142400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1735516800000",
"number": "1275965410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 PAGE RD N STE 1",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283740086",
"telephone_number": "910-715-8671",
"fax_number": "910-715-6878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 PAGE RD N STE 1",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283740086",
"telephone_number": "910-715-8671",
"fax_number": "910-715-6878"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCPC-14, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-07-30",
"last_updated": "2024-12-30",
"certification_date": "2024-12-30",
"status": "A",
"authorized_official_last_name": "FOSTER",
"authorized_official_first_name": "MICKEY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "910-715-4473"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "FIRSTHEALTH TRANSITION CARE CLINIC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "FIRSTHEALTH TRANSITION CARE CLINIC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Pinehurst, NC
- Ashley McNeill
- MCPC-10, LLC
- MCPC-11, LLC
- MCPC-12, LLC
- MCPC-12, LLC
- MCPC-14, LLC
- MCPC-17, LLC
- MCPC-18, LLC
- MCPC-19, LLC
- MCPC-20, LLC
All providers in Pinehurst, NC · Internal Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.