Active NPI
Antonio Cusi, M.D.
- Psychiatry Physician
- Jacksonville, NC
National Provider Identifier
1487643151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 38035
- Practice address
- 200 Tarpon TRL
Jacksonville, NC 28546-5287 - Phone
- (910) 938-1114
- Fax
- (910) 938-1118
- NPI assigned
- Oct 17, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 38035 | NC | Primary |
Addresses
Primary practice location
200 Tarpon TRL
Jacksonville, NC 28546-5287
Mailing address
200 Tarpon TRL
Jacksonville, NC 28546-5287
Phone (910) 938-1114
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8926642 | Medicaid | NC |
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 |
|---|---|---|---|
| 38035 | NC | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556150400000",
"number": "1487643151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 TARPON TRL",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285465287",
"telephone_number": "910-938-1114",
"fax_number": "910-938-1118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 TARPON TRL",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285465287",
"telephone_number": "910-938-1114",
"fax_number": "910-938-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUSI",
"first_name": "ANTONIO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-17",
"last_updated": "2019-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "38035",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8926642",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.