Active NPI
Wayne Frederick Homan Jr., MD
- Public Health & General Preventive Medicine Physician
- Fayetteville, NC
National Provider Identifier
1447412374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 2019-00952
- Practice address
- 1702 Owen Dr
Fayetteville, NC 28304-3419 - Phone
- (910) 323-3184
- NPI assigned
- Jul 1, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 0101246577 | VA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 0101246577 | VA | |
| Public Health & General Preventive Medicine Physician | 2083P0901X | 2019-00952 | NC | Primary |
Addresses
Primary practice location
1702 Owen Dr
Fayetteville, NC 28304-3419
Mailing address
590 Manning Drive
Campus Box 7595
Chapel Hill, NC 27599-7595
Phone (919) 966-2718
Other practice location 1
8901 Wisconsin Ave
Bethesda, MD 20889-0001
Phone (301) 295-4462
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019-00952 | NC | MD | Public Health & General Preventive Medicine Physician |
| 0101246577 | VA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587513600000",
"number": "1447412374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 MANNING DRIVE",
"address_2": "CAMPUS BOX 7595",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275997595",
"telephone_number": "919-966-2718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 OWEN DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043419",
"telephone_number": "910-323-3184"
}
],
"practiceLocations": [
{
"address_1": "8901 Wisconsin Ave",
"address_purpose": "LOCATION",
"city": "Bethesda",
"state": "MD",
"postal_code": "208890001",
"country_code": "US",
"telephone_number": "301-295-4462",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOMAN",
"first_name": "WAYNE",
"middle_name": "FREDERICK",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-01",
"last_updated": "2020-04-22",
"certification_date": "2020-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "VA",
"license": "0101246577",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "VA",
"license": "0101246577",
"primary": false
},
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "NC",
"license": "2019-00952",
"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 Apr 22, 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.