Cape Fear Valley Health System Specialty Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

H0213 Issued in NC

Legal business name

CAPE FEAR VALLEY HEALTH SYSTEM SPECIALTY GROUP, LLC

Practice address

104 W Southern Ave
Raeford, NC 28376-3218

Phone

(910) 615-3140

Fax

(910) 486-2169

NPI assigned

Mar 23, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Michael Nagowski

Title

Ceo

Phone

(910) 615-6700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CONVENIENT CARE FOR HOKE Doing business as

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1356665152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40908",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283090908",
            "telephone_number": "910-615-6448",
            "fax_number": "910-615-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W SOUTHERN AVE",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283763218",
            "telephone_number": "910-615-3140",
            "fax_number": "910-486-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPE FEAR VALLEY HEALTH SYSTEM SPECIALTY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-23",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "NAGOWSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-615-6700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "H0213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913981",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONVENIENT CARE FOR HOKE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cape Fear Valley Health System Specialty Group, LLC
• Maria Caplan
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• Chad Alan Carmichael, NRP
• Carolina 1St Choice Treatment Facility
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• Family Medicine Physician in Raeford, NC
• Providers in Raeford, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.