Individual provider Active NPI

Patrick Kavanaugh, M.D.

  • Family Medicine Physician
  • Durham, NC
National Provider Identifier
1689758740
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
98-00587 Issued in NC
Practice address
6020 Fayetteville Rd
Durham, NC 27713-9754
Phone
(919) 620-4467
NPI assigned
Oct 25, 2006
Last updated
Jan 29, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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 98-00587 NC Primary

Addresses

Primary practice location

6020 Fayetteville Rd
Durham, NC 27713-9754

Mailing address

6020 Fayetteville Rd
Triangle Family Practice
Durham, NC 27713-9754
Phone (919) 684-8111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100123000195 NC Practitioner - Family Practice 3476695891 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
98-00587NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Jan 6, 2021 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Current Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Current Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Jan 6, 2021 Accepting new patients

Locations

1901 Hillandale Rd
Ste D
Durham, NC 27705
Phone (919) 383-4355

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

5501 Fortunes Ridge Dr
Durham, NC 27713
Phone (919) 330-4147

6020 Fayetteville Rd
Durham, NC 27713
Phone (919) 572-2000

10211 Alm St
Raleigh, NC 27617
Phone (919) 206-4868

10211 Alm St
Ste 1100
Raleigh, NC 27617
Phone (919) 385-1160

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1689758740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 FAYETTEVILLE RD",
            "address_2": "TRIANGLE FAMILY PRACTICE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277139754",
            "telephone_number": "919-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 FAYETTEVILLE RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277139754",
            "telephone_number": "919-620-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "PATRICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "98-00587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.