Organization Active NPI

Mercy Medical Clinic, P. a.

  • Internal Medicine Physician
  • Goldsboro, NC
National Provider Identifier
1558490664
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
95-01199 Issued in NC
Legal business name
MERCY MEDICAL CLINIC, P. A.
Practice address
2501 Wayne Memorial Dr Ste a
Goldsboro, NC 27534-9436
Phone
(919) 736-0400
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Firas Chazli, M.D.
Title
President
Phone
(919) 736-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 95-01199 NC Primary

Addresses

Primary practice location

2501 Wayne Memorial Dr Ste a
Goldsboro, NC 27534-9436

Mailing address

PO Box 10707
Goldsboro, NC 27532-0707
Phone (919) 736-0400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558490664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10707",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275320707",
            "telephone_number": "919-736-0400",
            "fax_number": "919-736-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 WAYNE MEMORIAL DR STE A",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349436",
            "telephone_number": "919-736-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CLINIC, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAZLI",
        "authorized_official_first_name": "FIRAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-736-0400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "95-01199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.