Archdale Family Practice PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

30119 Issued in NC

Legal business name

ARCHDALE FAMILY PRACTICE PA

Practice address

11635 N Main St Ste E
Archdale, NC 27263-3271

Phone

(336) 861-4110

Fax

(336) 861-4295

NPI assigned

Jan 10, 2011

Last updated

Mar 11, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark Craig Beck, MDNPI 1487604831

Title

Owner

Phone

(336) 861-4110

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

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.

• Mark Craig Beck, MD

  • Family Medicine Physician
  • Archdale, NC
  • NPI 1487604831
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299801600000",
    "number": "1396049060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11635 N MAIN ST STE E",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272633271",
            "telephone_number": "336-861-4110",
            "fax_number": "336-861-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11635 N MAIN ST STE E",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272633271",
            "telephone_number": "336-861-4110",
            "fax_number": "336-861-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHDALE FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-03-11",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-861-4110",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "30119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8914271",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barton Adkins, PHARMD
• Affect Provider Group P.S.C.
• Affect Provider Group, P.S.C. (Affect Provider Group, P.C.)
• Agape & Harmony Enrichment Center LLC
• Archdale Drug Co Inc
• Tracy W Barber, MA CCC
• Otis Battles
• Mark Craig Beck, MD
• Sabrina Louise Bell, LCAS-P
• Jane Black, MA; CCC-SLP

• Family Medicine Physician in Archdale, NC
• Providers in Archdale, 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 Mar 11, 2011; 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.