NPIMap

Organization Active NPI

Cumberland County Hospital System Inc

Doing business as Cape Fear Valley Legacy Pediatrics

  • Pediatrics Physician
  • Fayetteville, NC
National Provider Identifier
1689445520
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Doing business as
Cape Fear Valley Legacy Pediatrics
Practice address
556 Sandhurst Dr
Fayetteville, NC 28304-4426
Phone
(910) 483-2646
Fax
(910) 483-9470
NPI assigned
Jan 10, 2024
Last updated
Jan 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Authorized official

Name
Joseph B Fiser
Title
VP Managed Care and Revenue Cycle
Phone
(910) 615-5572

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

556 Sandhurst Dr
Fayetteville, NC 28304-4426

Mailing address

PO Box 40908
Fayetteville, NC 28309-0908
Phone (910) 615-6949

Other practice location 1

1095 N Bragg Blvd Ste 104
Spring Lake, NC 28390-3307
Phone (910) 339-6015

Other names 1

  • Cape Fear Valley Legacy Pediatrics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031112000693 NC Part B Supplier - Clinic/Group Practice 1850204041 Receives reassigned benefits from 1,012 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Fayetteville, NC; Lillington, NC; Lumberton, NC; Raeford, NC; Red Springs, NC; Spring Lake, NC; Stedman, NC; Angier, NC…

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1689445520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40908",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283090908",
            "telephone_number": "910-615-6949",
            "fax_number": "910-615-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 SANDHURST DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044426",
            "telephone_number": "910-483-2646",
            "fax_number": "910-483-9470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1095 N Bragg Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Spring Lake",
            "state": "NC",
            "postal_code": "283903307",
            "country_code": "US",
            "telephone_number": "910-339-6015",
            "fax_number": "910-339-6017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CUMBERLAND COUNTY HOSPITAL SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "FISER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "VP MANAGED CARE AND REVENUE CYCLE",
        "authorized_official_telephone_number": "910-615-5572"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cape Fear Valley Legacy Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.