NPIMap

Organization Active NPI

Campbell University Health Center, LLC

  • Family Medicine Physician
  • Buies Creek, NC
National Provider Identifier
1508117185
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAMPBELL UNIVERSITY HEALTH CENTER, LLC
Practice address
129 TT Lanier St
Buies Creek, NC 27506
Phone
(910) 893-1562
Fax
(910) 893-1559
NPI assigned
Sep 24, 2012
Last updated
Mar 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2013

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

Authorized official

Name
James O Roberts
Title
Vice President for Business & Treas
Phone
(910) 893-1240

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X NU
Family Medicine Physician 207Q00000X NU Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU
Sports Medicine (Internal Medicine) Physician 207RS0010X NU
Physical Medicine & Rehabilitation Physician 208100000X NU

Addresses

Primary practice location

129 TT Lanier St
Buies Creek, NC 27506

Mailing address

PO Box 565
Buies Creek, NC 27506-0565
Phone (910) 893-1562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130221000497 NC Part B Supplier - Clinic/Group Practice 1254586308 Receives reassigned benefits from 11 practitioners
Practice locations: Dunn, NC; Buies Creek, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362700800000",
    "number": "1508117185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 565",
            "city": "BUIES CREEK",
            "state": "NC",
            "postal_code": "275060565",
            "telephone_number": "910-893-1562",
            "fax_number": "910-893-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 TT LANIER ST",
            "city": "BUIES CREEK",
            "state": "NC",
            "postal_code": "27506",
            "telephone_number": "910-893-1562",
            "fax_number": "910-893-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL UNIVERSITY HEALTH CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-24",
        "last_updated": "2013-03-08",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "VICE PRESIDENT FOR BUSINESS & TREAS",
        "authorized_official_telephone_number": "910-893-1240"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buies Creek, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.