Telica Chang Fong, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9247339 Issued in FL

Practice address

40 Autumn Fern TRL
Lillington, NC 27546-5155

Phone

(910) 364-0971

NPI assigned

Oct 11, 2018

Last updated

Oct 11, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: tchangfong@fcchc.directbygreenway.com

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1285109728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 TIDWORTH CT",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283766662",
            "telephone_number": "813-841-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 AUTUMN FERN TRL",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275465155",
            "telephone_number": "910-364-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG FONG",
        "first_name": "TELICA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9247339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kutreni Lachelle Carter, FNP-C
• Martika Carter, RBT
• Kyle Caruolo, DPT
• Catherine B Evans Family Dentistry
• Sandra Deanne Chadwick, PHARM.D., B.S., B.S.
• Charles V. Sikes Jr (Family Eye Care Optometry)
• Kiana Cherry
• Wayne Eric Chew, BA, QP
• Christian Values ABA
• Christian Values ABA

• Family Nurse Practitioner in Lillington, NC
• Providers in Lillington, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.