MCPC-21, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MCPC-21, LLC

Practice address

522 Allen St Ste 203
Troy, NC 27371-2861

Phone

(910) 571-5170

Fax

(910) 571-5175

NPI assigned

Sep 25, 2020

Organization subpart

No

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

Authorized official

Name

Mickey Foster

Title

Ceo

Phone

(910) 715-4473

Specialties & licenses 1

Addresses

Other names 1

• FirstHealth Occupational Health and Wellness Doing business as

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1407463227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 ALLEN ST STE 203",
            "city": "TROY",
            "state": "NC",
            "postal_code": "273712861",
            "telephone_number": "910-571-5170",
            "fax_number": "910-571-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 ALLEN ST STE 203",
            "city": "TROY",
            "state": "NC",
            "postal_code": "273712861",
            "telephone_number": "910-571-5170",
            "fax_number": "910-571-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCPC-21, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-715-4473"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FirstHealth Occupational Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mickey Lilly
• Theodore Christopher Mataxis III, M.A., L.P.A
• Jamie Danielle McDonald, OA
• Michael Scott McLeod, MD
• Lisa Cockman McMasters, RN
• MCPC-6, LLC
• Mid Carolina Family Medicine, P.a.
• Midel Incorporated
• Milestone Recovery Services LLC
• Monarch

• All providers in Troy, NC
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.