NPIMap

Individual provider Active NPI

George Constantine Pantelakos, MD

  • Family Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1679597025
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39456 Issued in NC
Practice address
1248 Fort Bragg Rd
Fayetteville, NC 28305-4981
Phone
(910) 323-0334
Fax
(888) 391-5874
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39456 NC Primary

Addresses

Primary practice location

1248 Fort Bragg Rd
Fayetteville, NC 28305-4981

Mailing address

1248 Fort Bragg Rd
Fayetteville, NC 28305-4981
Phone (910) 323-0334

Other identifiers 1

IdentifierTypeStateIssuer
896518EMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080604000165 NC Practitioner - Family Practice 8022188903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1248 Fort Bragg Rd
Suite 101
Fayetteville, NC 28305-4982
Phone (910) 323-0334

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Fear Valley Health Medical Group LLC CurrentSince Apr 14, 2025 Accepting new patients
Cape Fear Valley Health Medical Group LLC Family Medicine CurrentSince Apr 14, 2025 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Feb 24, 2022 Accepting new patients
Cumberland County Hospital System Inc Family Medicine CurrentSince Feb 24, 2022 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Cape Fear Valley Health Medical Group LLC Current Accepting new patients

Locations

4140 Ferncreek Dr
Ste 801
Fayetteville, NC 28314
Phone (910) 484-2171

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

1248 Fort Bragg Rd
Ste 101
Fayetteville, NC 28305
Phone (910) 323-0334

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1679597025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1248 FORT BRAGG RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283054981",
            "telephone_number": "910-323-0334",
            "fax_number": "888-391-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 FORT BRAGG RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283054981",
            "telephone_number": "910-323-0334",
            "fax_number": "888-391-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTELAKOS",
        "first_name": "GEORGE",
        "middle_name": "CONSTANTINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "39456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "896518E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.