NPIMap

Organization Active NPI

Healthstat Onsite Clinic Goodyear-Fayetteville

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1548817976
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
Legal business name
HEALTHSTAT ONSITE CLINIC GOODYEAR-FAYETTEVILLE
Practice address
6650 Ramsey St
Fayetteville, NC 28311-9318
Phone
(704) 936-5546
NPI assigned
Aug 21, 2019
Last updated
Aug 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Authorized official

Name
Jill Johnson Patton
Title
Director of Risk Management
Phone
(704) 936-5546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X Primary

Addresses

Primary practice location

6650 Ramsey St
Fayetteville, NC 28311-9318

Mailing address

4651 Charlotte Park Dr Ste 300
Charlotte, NC 28217-1916
Phone (704) 935-5546

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2172190Healthstat Onsite Clinic6650 Ramsey Street, Fayetteville, NC 28311Certificate of waiverSep 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Healthstat Onsite Clinic Parkdale Plant 16237 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

6650 Ramsey St
Fayetteville, NC 28311
Phone (910) 488-9295

NPI Registry JSON

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1548817976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 CHARLOTTE PARK DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171916",
            "telephone_number": "704-935-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283119318",
            "telephone_number": "704-936-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAT ONSITE CLINIC GOODYEAR-FAYETTEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "DIRECTOR OF RISK MANAGEMENT",
        "authorized_official_telephone_number": "704-936-5546"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.