NPIMap

Organization Active NPI

Fayetteville Orthopaedic Clinic, PA

Doing business as Fayetteville Orthopaedics and Sports Medicine

  • Orthopaedic Surgery Physician
  • Fayetteville, NC
National Provider Identifier
1417919390
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
FAYETTEVILLE ORTHOPAEDIC CLINIC, PA
Doing business as
Fayetteville Orthopaedics and Sports Medicine
Practice address
1991 Fordham Dr
Suite 100
Fayetteville, NC 28304-3650
Phone
(910) 484-3114
Fax
(910) 484-8824
NPI assigned
Apr 5, 2006
Last updated
May 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2012

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

Authorized official

Name
James Erwin Johnson, M.D.NPI 1346243052
Title
Practice Administrator
Phone
(910) 223-2007

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
Orthopaedic Surgery Physician 207X00000X NC Primary

Addresses

Primary practice location

1991 Fordham Dr
Suite 100
Fayetteville, NC 28304-3650

Mailing address

1991 Fordham Drive
Ste 100
Fayetteville, NC 28304
Phone (910) 484-3114

Other identifiers 1

IdentifierTypeStateIssuer
8901555MedicaidNC

Other names 1

  • Fayetteville Orthopaedics and Sports Medicine Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1417919390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 FORDHAM DRIVE",
            "address_2": "STE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-484-3114",
            "fax_number": "910-484-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 FORDHAM DR",
            "address_2": "SUITE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043650",
            "telephone_number": "910-484-3114",
            "fax_number": "910-484-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE ORTHOPAEDIC CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ERWIN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "910-223-2007",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901555",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fayetteville Orthopaedics and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 4, 2012; 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.