NPIMap

Organization Active NPI

Med First Immediate Care & Family Practice, PA

  • Family Medicine Physician
  • Thomasville, NC
National Provider Identifier
1316455124
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PA
Practice address
1033 Randolph St Ste 32
Thomasville, NC 27360-5731
Phone
(336) 860-0843
Fax
(336) 914-8303
NPI assigned
Jan 15, 2018
Last updated
Jan 21, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MED FIRST IMMEDIATE CARE & FAMILY PRACTICE, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Authorized official

Name
Paul Feneck
Title
Ceo
Phone
(919) 341-4016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1033 Randolph St Ste 32
Thomasville, NC 27360-5731

Mailing address

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2142538Med First Immediate Care and1033 Randolph Street, Suite 32, Thomasville, NC 27360Certificate of waiverJan 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Med First Immediate Care F44 organizations share this tax ID, including this one
Part of
Med First Immediate Care F

Other organizations with this tax ID 43

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

View all 43

Locations

1023 Randolph St
Ste 32
Thomasville, NC 27360

1033 Randolph St
Ste 32
Thomasville, NC 27360
Phone (336) 860-0843

Practitioners & affiliated clinicians

Practitioners 3

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": "1515974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1316455124",
    "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": "1033 RANDOLPH ST STE 32",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273605731",
            "telephone_number": "336-860-0843",
            "fax_number": "336-914-8303"
        }
    ],
    "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": "2018-01-15",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "FENECK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-341-4016"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.