Garner Family Practice PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

40380 Issued in NC

Legal business name

GARNER FAMILY PRACTICE PA

Practice address

801 Poole Dr
Garner, NC 27529

Phone

(919) 779-1440

Fax

(919) 662-0613

NPI assigned

Apr 19, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Julia Wall

Title

Office Manager

Phone

(919) 779-0811

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Johnny Wayne Bagwell, MD

  • Family Medicine Physician
  • Garner, NC
  • NPI 1568424869

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1700841103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 POOLE DR",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275295207",
            "telephone_number": "919-779-1440",
            "fax_number": "919-662-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 POOLE DR",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "27529",
            "telephone_number": "919-779-1440",
            "fax_number": "919-662-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARNER FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "919-779-0811",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "40380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013M8",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Garner Behavioral Hospital, LLC
• Garner Behavioral Hospital, LLC
• Garner Chiropractic & Wellness Center LLC
• Garner Emergency Medical Services and Rescue Squad, Inc.
• Garner Family Care Services, LLC.
• Garner Internal Medicine, P.a.
• Garner Lighthouse
• Garner Lighthouse
• Garner Mental Health, PLLC
• Garner Psychiatry, PLLC

• All providers in Garner, NC
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.