NPIMap

Organization Active NPI

DLP Maria Parham Physician Practices, LLC

Doing business as Maria Parham Primary Care

  • Family Medicine Physician
  • Henderson, NC
National Provider Identifier
1720364649
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DLP MARIA PARHAM PHYSICIAN PRACTICES, LLC
Doing business as
Maria Parham Primary Care
Practice address
511 Ruin Creek Rd
Suite 101
Henderson, NC 27536-5919
Phone
(252) 436-0440
Fax
(252) 436-0281
NPI assigned
Oct 24, 2011
Last updated
Dec 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Authorized official

Name
Timothy Vaughn
Title
Vice President
Phone
(252) 436-1674

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

511 Ruin Creek Rd
Suite 101
Henderson, NC 27536-5919

Mailing address

120 Charles Rollins Rd
Suite 206
Henderson, NC 27536-2882
Phone (252) 436-0440

Other names 1

  • Maria Parham Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111222000550 NC Part B Supplier - Clinic/Group Practice 7719153683 Receives reassigned benefits from 181 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Henderson, NC; Louisburg, NC; Oxford, NC; Wake Forest, NC

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "number": "1720364649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CHARLES ROLLINS RD",
            "address_2": "SUITE 206",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362882",
            "telephone_number": "252-436-0440",
            "fax_number": "252-436-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 RUIN CREEK RD",
            "address_2": "SUITE 101",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365919",
            "telephone_number": "252-436-0440",
            "fax_number": "252-436-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLP MARIA PARHAM PHYSICIAN PRACTICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-24",
        "last_updated": "2016-12-06",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "252-436-1674"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maria Parham Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.