Organization Active NPI

Tabor City Family Medical Clinic, PC

  • Family Medicine Physician
  • Tabor City, NC
National Provider Identifier
1548828965
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TABOR CITY FAMILY MEDICAL CLINIC, PC
Practice address
706 E 5TH St Unit B
Tabor City, NC 28463-2335
Phone
(910) 207-3697
NPI assigned
May 31, 2019
Organization subpart
Yes
Parent organization
TABOR CITY FAMILY MEDICAL CLINIC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Authorized official

Name
Faith Beking, FNPNPI 1427544915
Title
Owner
Phone
(910) 377-8002

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

706 E 5TH St Unit B
Tabor City, NC 28463-2335

Mailing address

706 E 5TH St Unit B
Tabor City, NC 28463-2335
Phone (910) 377-8002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190829002440 NC Part B Supplier - Clinic/Group Practice 9133457047 Receives reassigned benefits from 1 practitioner
Practice locations: Tabor City, NC

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
34D2165975Tabor City Family Medical Clinic706 East 5TH Street, Unit B, Tabor City, NC 28463Certificate of waiverMay 8, 2027

National Provider Directory

National Provider Directory
Part of
Tabor City Family Medical Clinic PC

Locations

706 E 5th St
Unit B
Tabor City, NC 28463
Phone (910) 377-3293

Practitioners & affiliated clinicians

Practitioners 1

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": "1559260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563408000000",
    "number": "1548828965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 E 5TH ST UNIT B",
            "city": "TABOR CITY",
            "state": "NC",
            "postal_code": "284632335",
            "telephone_number": "910-377-8002",
            "fax_number": "910-377-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 E 5TH ST UNIT B",
            "city": "TABOR CITY",
            "state": "NC",
            "postal_code": "284632335",
            "telephone_number": "910-207-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABOR CITY FAMILY MEDICAL CLINIC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TABOR CITY FAMILY MEDICAL CLINIC, PC",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-07-18",
        "status": "A",
        "authorized_official_last_name": "BEKING",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-377-8002",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tabor City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.