Individual provider Active NPI

Charles Patrick Fresco III, PA-C

  • Medical Physician Assistant
  • Fort Bragg, NC
National Provider Identifier
1477288611
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-12865 Issued in NC
Practice address
2817 Rock Merritt Ave Stop a
Fort Bragg, NC 28310-0001
Phone
(910) 908-8282
NPI assigned
Jul 21, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X 0010-12865 NC Primary

Addresses

Primary practice location

2817 Rock Merritt Ave Stop a
Fort Bragg, NC 28310-0001

Mailing address

2817 Rock Merritt Ave Stop a
Fort Bragg, NC 28310-0001
Phone (910) 907-8282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230126001525 NC Practitioner - Physician Assistant 9032580238 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinehurst Medical Clinic IncGroup PAC ID 5991617169, 162 clinicians
Cfvhs Ed PhysiciansGroup PAC ID 2961316237, 27 clinicians
Hoke Emergency Group, PCGroup PAC ID 7214200146, 44 clinicians

Practice addresses (Care Compare)

15 Regional Dr
Pinehurst, NC 28374-8850
Phone (910) 295-5511

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-8780

200 Pavilion Way
Southern Pines, NC 28387-4561
Phone (910) 295-5511

205 Page Rd
Pinehurst, NC 28374-8749
Phone (910) 295-5511

210 Medical Pavilion Dr
Raeford, NC 28376-9111
Phone (910) 904-8000

555 Carthage St
Sanford, NC 27330-4104
Phone (919) 774-6518

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Medical Center Incorporated CurrentSince Jan 12, 2023 Accepting new patients
Goshen Medical Center Incorporated Current Accepting new patients
Goshen Medical Center Incorporated CurrentSince Jan 12, 2023 Accepting new patients
Pinehurst Medical Clinic, Inc. CurrentSince Dec 1, 2023 Accepting new patients
Pinehurst Medical Clinic, Inc. Past Accepting new patients

Locations

444 SW Center St
Faison, NC 28341
Phone (910) 267-0421

205 Page Rd
Pinehurst, NC 28374
Phone (910) 295-9211

102 Southern Ave
Raeford, NC 28376
Phone (910) 248-4600

555 Carthage St
Sanford, NC 27330
Phone (919) 774-6518

200 Pavilion Way
Southern Pines, NC 28387
Phone (910) 235-3330

Interoperability endpoints

  • Direct secure messaging: cfresco@goshenmedical.cloudcraftdirect.com
  • Direct secure messaging: charlesfresco@phmc.allscriptsdirect.net

Organizations & group practices 8

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1477288611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE STOP A",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE STOP A",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-908-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRESCO",
        "first_name": "CHARLES",
        "middle_name": "PATRICK",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-12865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

Verify at the official NPI Registry.