Active NPI
Waynesville Family Practice Center PA
- Family Medicine Physician
- Waynesville, NC
National Provider Identifier
1376631093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 40685
- Legal business name
- WAYNESVILLE FAMILY PRACTICE CENTER PA
- Practice address
- 1272 East Street
Waynesville, NC 28786-3437 - Phone
- (828) 456-3511
- Fax
- (828) 456-3583
- NPI assigned
- Oct 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Wayne Pass, MD
- Title
- President
- Phone
- (828) 456-3511
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 40685 | NC | Primary |
Addresses
Primary practice location
1272 East Street
Waynesville, NC 28786-3437
Mailing address
1272 East Street
Waynesville, NC 28786-3437
Phone (828) 456-3511
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8902994 | Medicaid | NC | |
| 02994 | Other | NC | BC/BS NC |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D0684908 | Waynesville Family Practice | Certificate of waiver | Apr 30, 2028 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Waynesville, NC
- NPI 1497843486
-
- Physician Assistant
- Asheville, NC
- NPI 1407846777
-
- Family Medicine Physician
- Waynesville, NC
- NPI 1356435465
-
- Family Medicine Physician
- Waynesville, NC
- NPI 1699869701
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1279584000000",
"number": "1376631093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1272 EAST STREET",
"city": "WAYNESVILLE",
"state": "NC",
"postal_code": "287863437",
"telephone_number": "828-456-3511",
"fax_number": "828-456-3583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1272 EAST STREET",
"city": "WAYNESVILLE",
"state": "NC",
"postal_code": "287863437",
"telephone_number": "828-456-3511",
"fax_number": "828-456-3583"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WAYNESVILLE FAMILY PRACTICE CENTER PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-10",
"last_updated": "2010-07-20",
"status": "A",
"authorized_official_last_name": "PASS",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "WAYNE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "828-456-3511",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "NC",
"license": "40685",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8902994",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS NC",
"identifier": "02994",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waynesville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; 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.