Organization Active NPI

Robeson Medical Clinic

  • Internal Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1679663611
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ROBESON MEDICAL CLINIC
Practice address
1750 Metromedical Dr
Fayetteville, NC 28304-3861
Phone
(910) 223-3123
Fax
(910) 223-3122
NPI assigned
Oct 13, 2006
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
Sandhya Anne Thomas-Montilus, M.D.NPI 1720047194
Title
Ceo
Phone
(910) 738-2330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1750 Metromedical Dr
Fayetteville, NC 28304-3861

Mailing address

1750 Metromedical Dr
Fayetteville, NC 28304-3861
Phone (910) 223-3123

Other identifiers 1

IdentifierTypeStateIssuer
89-0226CMedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679663611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 METROMEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043861",
            "telephone_number": "910-223-3123",
            "fax_number": "910-223-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 METROMEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043861",
            "telephone_number": "910-223-3123",
            "fax_number": "910-223-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBESON MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THOMAS-MONTILUS",
        "authorized_official_first_name": "SANDHYA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-738-2330",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-0226C",
            "state": "NC"
        }
    ],
    "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 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.