NPIMap

Organization Active NPI

Med First Immediate Care & Family Practice PA

  • Family Medicine Physician
  • Richlands, NC
National Provider Identifier
1447780804
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PA
Practice address
154 Beulaville Hwy
Richlands, NC 28574-7104
Phone
(910) 324-9935
Fax
(910) 324-9938
NPI assigned
Jun 18, 2017
Last updated
Jan 21, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Authorized official

Name
Mr. Paul Feneck
Title
Chief Executive Officer
Phone
(919) 341-4016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

154 Beulaville Hwy
Richlands, NC 28574-7104

Mailing address

1616 E Millbrook Rd Ste 110
Raleigh, NC 27609-4971
Phone (919) 341-4016

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1060298Med First Immediate Care &154 Beulaville Highway, Richlands, NC 28574Certificate of waiverNov 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Med First Immediate Care F44 organizations share this tax ID, including this one
Part of
Med First Immediate Care F

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

154 Beulaville Hwy
Richlands, NC 28574
Phone (910) 324-9935

NPI Registry JSON

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1447780804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 E MILLBROOK RD STE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094971",
            "telephone_number": "919-341-4016",
            "fax_number": "910-346-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 BEULAVILLE HWY",
            "city": "RICHLANDS",
            "state": "NC",
            "postal_code": "285747104",
            "telephone_number": "910-324-9935",
            "fax_number": "910-324-9938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MED FIRST IMMEDIATE CARE & FAMILY PRACTICE PA",
        "enumeration_date": "2017-06-18",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "FENECK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "919-341-4016",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richlands, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.