Organization Active NPI

Medac Health Services, PA

Doing business as Medac Urgent Care

  • Emergency Medicine Physician
  • Wilmington, NC
National Provider Identifier
1578746236
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MEDAC HEALTH SERVICES, PA
Doing business as
Medac Urgent Care
Practice address
1442 Military Cutoff Rd
Wilmington, NC 28403-3605
Phone
(910) 256-6088
Fax
(910) 256-6089
NPI assigned
Dec 17, 2007
Organization subpart
Yes
Parent organization
MEDAC HEALTH SERVICES, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
David Maloney
Title
Ceo
Phone
(616) 656-2750

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

1442 Military Cutoff Rd
Wilmington, NC 28403-3605

Mailing address

216 Centerview Dr Ste 100
Brentwood, TN 37027-3226
Phone (910) 791-0075

Other identifiers 2

IdentifierTypeStateIssuer
07651OtherNCBCBS
CC2877OtherNCRAILROAD MEDICARE

Other names 1

  • Medac Urgent Care Doing business as

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
34D0914474Medac Health Services, PD Dba Medac Military1442 Military Cutoff Road, Wilmington, NC 28403Certificate of waiverApr 30, 2028

National Provider Directory

National Provider Directory
Part of
Medac Ecep

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1578746236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 CENTERVIEW DR STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273226",
            "telephone_number": "910-791-0075",
            "fax_number": "615-656-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1442 MILITARY CUTOFF RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033605",
            "telephone_number": "910-256-6088",
            "fax_number": "910-256-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDAC HEALTH SERVICES, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDAC HEALTH SERVICES, PA",
        "enumeration_date": "2007-12-17",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "MALONEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-656-2750"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "07651",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC2877",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medac Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.