Organization Active NPI

Hematology & Oncology Associates of Fayetteville, P.a.

  • Hematology & Oncology Physician
  • Fayetteville, NC
National Provider Identifier
1528022126
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
9900923 Issued in NC
Legal business name
HEMATOLOGY & ONCOLOGY ASSOCIATES OF FAYETTEVILLE, P.A.
Practice address
1638 Owen Dr
Fayetteville, NC 28304-3424
Phone
(910) 615-6910
Fax
(910) 615-5219
NPI assigned
Apr 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Authorized official

Name
Kamal Manubhai Bakri, M.D.
Title
President
Phone
(910) 615-6914

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RH0003X 9900923 NC Primary
Medical Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RX0202X 26183 NC
Medical Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RX0202X 32779 NC
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X 200943 NC

Addresses

Primary practice location

1638 Owen Dr
Fayetteville, NC 28304-3424

Mailing address

PO Box 42935
Fayetteville, NC 28309-2935
Phone (910) 615-6910

Other identifiers 1

IdentifierTypeStateIssuer
890239QMedicaidNC

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1528022126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42935",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283092935",
            "telephone_number": "910-615-6910",
            "fax_number": "910-615-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-6910",
            "fax_number": "910-615-5219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEMATOLOGY & ONCOLOGY ASSOCIATES OF FAYETTEVILLE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "BAKRI",
        "authorized_official_first_name": "KAMAL",
        "authorized_official_middle_name": "MANUBHAI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-615-6914",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "9900923",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": "26183",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": "32779",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "200943",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890239Q",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.