NPIMap

Organization Active NPI

Pura Clinic Family Medicine PC

  • Urgent Care Clinic/Center
  • Fayetteville, NC
National Provider Identifier
1609296128
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PURA CLINIC FAMILY MEDICINE PC
Practice address
124 Baywood Rd
Suite 111
Fayetteville, NC 28312-8733
Phone
(910) 829-5108
Fax
(910) 829-5107
NPI assigned
Apr 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Authorized official

Name
Dr. Mohamad A. Shakir, M.D.
Title
Owner
Phone
(910) 829-5108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

124 Baywood Rd
Suite 111
Fayetteville, NC 28312-8733

Mailing address

PO Box 4860
Murrells Inlet, SC 29576-2698
Phone (843) 651-2624

National Provider Directory

National Provider Directory
Tax ID family
Pura Clinic Family Medicine PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1609296128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4860",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295762698",
            "telephone_number": "843-651-2624",
            "fax_number": "843-357-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 BAYWOOD RD",
            "address_2": "SUITE 111",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283128733",
            "telephone_number": "910-829-5108",
            "fax_number": "910-829-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURA CLINIC FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "SHAKIR",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-829-5108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "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 Apr 23, 2014; 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.