Organization Active NPI

Alamance Internal and Nuclear Medicine

  • Endocrinology, Diabetes & Metabolism Physician
  • Burlington, NC
National Provider Identifier
1538401161
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
9700604 Issued in NC
Legal business name
ALAMANCE INTERNAL AND NUCLEAR MEDICINE
Practice address
2961 Crouse LN
Suite a
Burlington, NC 27215-8833
Phone
(336) 586-9799
Fax
(336) 586-9760
NPI assigned
Mar 21, 2013
Last updated
Mar 21, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
ALAMANCE INTERNAL AND NUCLEAR MEDICINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Authorized official

Name
Dr. Fayegh Jadali, M.D.NPI 1427144104
Title
Physician
Phone
(336) 586-9799

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 9700604 NC Primary

Addresses

Primary practice location

2961 Crouse LN
Suite a
Burlington, NC 27215-8833

Mailing address

2961 Crouse LN
Suite a
Burlington, NC 27215-8833
Phone (336) 586-9799

Other identifiers 1

IdentifierTypeStateIssuer
891042XMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130515000151 NC Part B Supplier - Clinic/Group Practice 9335386192 Receives reassigned benefits from 1 practitioner
Practice locations: Burlington, NC

National Provider Directory

National Provider Directory
Part of
Alamance Internal Nuclear

Locations

2961 Crouse Ln
#A
Burlington, NC 27215
Phone (336) 586-9799

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363824000000",
    "number": "1538401161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 CROUSE LN",
            "address_2": "SUITE A",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158833",
            "telephone_number": "336-586-9799",
            "fax_number": "336-586-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961 CROUSE LN",
            "address_2": "SUITE A",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158833",
            "telephone_number": "336-586-9799",
            "fax_number": "336-586-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAMANCE INTERNAL AND NUCLEAR MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALAMANCE INTERNAL AND NUCLEAR MEDICINE",
        "enumeration_date": "2013-03-21",
        "last_updated": "2013-03-21",
        "status": "A",
        "authorized_official_last_name": "JADALI",
        "authorized_official_first_name": "FAYEGH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "336-586-9799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "9700604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891042X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.