NPIMap

Organization Active NPI

Pelican Family Medicine, P.a.

  • Family Medicine Physician
  • Wilmington, NC
National Provider Identifier
1326678236
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PELICAN FAMILY MEDICINE, P.A.
Doing business as
Pelican Family Medicine at Physicians Drive
Practice address
1602 Physicians Dr Ste 105
Wilmington, NC 28401-7350
Phone
(910) 762-8077
Fax
(910) 762-2760
NPI assigned
Jan 20, 2020
Organization subpart
Yes
Parent organization
PELICAN FAMILY MEDICINE, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Authorized official

Name
Mark Samuel Thomas Armitage, MDNPI 1912952847
Title
Owner/Physician
Phone
(910) 792-1001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1602 Physicians Dr Ste 105
Wilmington, NC 28401-7350

Mailing address

5429 Wrightsville Ave
Wilmington, NC 28403-6513
Phone (910) 792-1001

Other names 1

  • Pelican Family Medicine at Physicians Drive Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081119000282 NC Part B Supplier - Clinic/Group Practice 0941360010 Receives reassigned benefits from 10 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilmington, NC

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Pelican Family Medicinep

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1326678236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 WRIGHTSVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036513",
            "telephone_number": "910-792-1001",
            "fax_number": "910-792-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 PHYSICIANS DR STE 105",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017350",
            "telephone_number": "910-762-8077",
            "fax_number": "910-762-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELICAN FAMILY MEDICINE, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PELICAN FAMILY MEDICINE, P.A.",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "ARMITAGE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "SAMUEL THOMAS",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "910-792-1001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pelican Family Medicine at Physicians Drive",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.