Organization Active NPI

Murray Fork Clinic, PC

  • Psychiatry Physician
  • Fayetteville, NC
National Provider Identifier
1417310491
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MURRAY FORK CLINIC, PC
Practice address
6020 Morganton Road
Fayetteville, NC 28314-1352
Phone
(910) 764-4750
Fax
(910) 764-4752
NPI assigned
Mar 29, 2016
Organization subpart
Yes
Parent organization
MURRAY FORK CLINIC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Authorized official

Name
Nerva Augustin, M.D.NPI 1740255041
Title
MD/Ceo/Owner
Phone
(910) 764-4750

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

6020 Morganton Road
Fayetteville, NC 28314-1352

Mailing address

6020 Morganton Road
Fayetteville, NC 28314-1352
Phone (910) 764-4750

National Provider Directory

National Provider Directory
Part of
Murray Fork Clinic PC

Locations

6020 Morganton Rd
Fayetteville, NC 28314
Phone (910) 764-4750

Practitioners & affiliated clinicians

Practitioners 1

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": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1417310491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 MORGANTON ROAD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141352",
            "telephone_number": "910-764-4750",
            "fax_number": "910-764-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 MORGANTON ROAD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141352",
            "telephone_number": "910-764-4750",
            "fax_number": "910-764-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MURRAY FORK CLINIC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MURRAY FORK CLINIC, PC",
        "enumeration_date": "2016-03-29",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "AUGUSTIN",
        "authorized_official_first_name": "NERVA",
        "authorized_official_title_or_position": "MD/CEO/OWNER",
        "authorized_official_telephone_number": "910-764-4750",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.