NPIMap

Organization Active NPI

Louisburg Family Practice and Pain Management PLLC

  • Family Medicine Physician
  • Louisburg, NC
National Provider Identifier
1295063279
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25447 Issued in NC
Legal business name
LOUISBURG FAMILY PRACTICE AND PAIN MANAGEMENT PLLC
Practice address
1501 N Bickett Blvd
Suite G
Louisburg, NC 27549-2178
Phone
(919) 496-1247
Fax
(919) 496-3307
NPI assigned
Dec 2, 2009
Last updated
Mar 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Authorized official

Name
Phillip Earl Stover, MDNPI 1770542318
Title
Medical Director / Owner
Phone
(919) 496-1247

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 25447 NC Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X 25447 NC

Addresses

Primary practice location

1501 N Bickett Blvd
Suite G
Louisburg, NC 27549-2178

Mailing address

PO Box 239
Louisburg, NC 27549-0239
Phone (919) 496-1247

National Provider Directory

National Provider Directory

Locations

1501 N Bickett Blvd
Louisburg, NC 27549
Phone (919) 496-1247

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11901/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1295063279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 239",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275490239",
            "telephone_number": "919-496-1247",
            "fax_number": "919-496-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N BICKETT BLVD",
            "address_2": "SUITE G",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492178",
            "telephone_number": "919-496-1247",
            "fax_number": "919-496-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISBURG FAMILY PRACTICE AND PAIN MANAGEMENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-02",
        "last_updated": "2010-03-10",
        "status": "A",
        "authorized_official_last_name": "STOVER",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / OWNER",
        "authorized_official_telephone_number": "919-496-1247",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "25447",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NC",
            "license": "25447",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.