NPIMap

Individual provider Active NPI

Brian Matthew Kaltenecker, DO

  • Obstetrics & Gynecology Physician
  • Fayetteville, NC
National Provider Identifier
1477075596
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2021-00560 Issued in NC
Practice address
2950 Village Dr Ste 100
Fayetteville, NC 28304-4129
Phone
(910) 323-3301
NPI assigned
Jul 11, 2017
Last updated
Nov 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2021-00560 NC Primary

Addresses

Primary practice location

2950 Village Dr Ste 100
Fayetteville, NC 28304-4129

Mailing address

2950 Village Dr
Fayetteville, NC 28304-4128
Phone (910) 323-3301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211222000057 NC Practitioner - Obstetrics/Gynecology 0941573158 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Wellness Center PAGroup PAC ID 5395706840, 5 clinicians

Practice addresses (Care Compare)

2950 Village Dr
Fayetteville, NC 28304-3815
Phone 91032333014

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2021-00560NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Womens Wellness Center, P.a. Obstetrics & Gynecology CurrentSince Sep 18, 2021 Accepting new patients
Hoke Healthcare, LLC Obstetrics & Gynecology CurrentSince Jan 30, 2024 Accepting new patients
Cumberland County Hospital System Inc Obstetrics & Gynecology CurrentSince Jun 28, 2023 Accepting new patients
Hoke Healthcare LLC CurrentSince Jan 30, 2024 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Cumberland County Hospital System Inc CurrentSince Jun 28, 2023 Accepting new patients

Locations

1341 Walter Reed Rd
Fayetteville, NC 28304
Phone (910) 609-3500

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

2950 Village Dr
Fayetteville, NC 28304
Phone (910) 323-3301

2950 Village Dr
Ste 100
Fayetteville, NC 28304
Phone (910) 323-3301

300 Medical Pavilion Dr
#25
Raeford, NC 28376
Phone (910) 904-8035

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1477075596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 VILLAGE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044128",
            "telephone_number": "910-323-3301",
            "fax_number": "910-323-4207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 VILLAGE DR STE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044129",
            "telephone_number": "910-323-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALTENECKER",
        "first_name": "BRIAN",
        "middle_name": "MATTHEW",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-11",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2021-00560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.