Fayetteville Area Health Education Foundation, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

L004639 Issued in NC

Legal business name

FAYETTEVILLE AREA HEALTH EDUCATION FOUNDATION, INC.

Doing business as

Southern Regional AHEC

Practice address

1601 Owen Dr
Fayetteville, NC 28304-3425

Phone

(910) 678-0100

Fax

(910) 678-0115

NPI assigned

Aug 25, 2016

Last updated

Aug 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sushma Kapoor, M.D.NPI 1497804421

Title

VP Ceas

Phone

(910) 678-0100

Specialties & licenses 1

Addresses

Other names 1

• Southern Regional AHEC Doing business as

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sushma Surrinder Kapoor, M.D.

  • Family Medicine Physician
  • Fayetteville, NC
  • NPI 1497804421
  Authorized official Same address or phone

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1639625106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043425",
            "telephone_number": "910-678-0100",
            "fax_number": "910-678-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043425",
            "telephone_number": "910-678-0100",
            "fax_number": "910-678-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE AREA HEALTH EDUCATION FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-25",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "KAPOOR",
        "authorized_official_first_name": "SUSHMA",
        "authorized_official_title_or_position": "VP CEAS",
        "authorized_official_telephone_number": "910-678-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "L004639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Regional AHEC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fayetteville Al Holdings, LLC (Hertiage Suites)
• Fayetteville Allstar Wheelchair Sports Team
• Fayetteville Ambulatory Surgery Center LLC (Fayetteville Ambulatory Surgery Center)
• Fayetteville Anesthesia, P.a.
• Fayetteville Area Health Education Foundation Inc (Southern Regional Area Health Education Center)
• Fayetteville Associates in Laboratory Medicine
• Fayetteville Breastfeeding Center Inc
• Fayetteville Children's Clinic, P.a.
• Fayetteville Chiropractic (Fayetteville Family Chiropractic)
• Fayetteville Chiropractic Solutions PA

• Primary Care Clinic/Center in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.