Statcare, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9700722 Issued in NC

Legal business name

STATCARE, LLC

Doing business as

StatCare Urgent Care Clinic

Practice address

9525 Cliffdale Rd.
Fayetteville, NC 28304

Phone

(910) 826-7925

Fax

(910) 864-7925

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Raju B Raval, D.O.NPI 1962403196

Title

Medical Director

Phone

(910) 826-7828

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• StatCare Urgent Care Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Statcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Statcare,LLC

  • Internal Medicine Physician
  • Fayetteville, NC
  • NPI 1053669002
  NPD tax ID

Practitioners 1

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.

• Raju B Raval, DO

  • Internal Medicine Physician
  • Fayetteville, NC
  • NPI 1962403196
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374192000000",
    "number": "1750448791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 87707",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-826-7828",
            "fax_number": "910-864-7925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 CLIFFDALE RD.",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-826-7925",
            "fax_number": "910-864-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2013-07-19",
        "status": "A",
        "authorized_official_last_name": "RAVAL",
        "authorized_official_first_name": "RAJU",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "910-826-7828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9700722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "027AU",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903128",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "StatCare Urgent Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacqueline Humphrey Starks, LPTA
• Quenicia Nobles Starks, MSOT, OTR/L
• Teressa Starr, DO
• Stash Home Care Agency LLC
• Kimberly Marie Staszko, CRNA
• Statcare,LLC
• State of NC Division of Health Services
• Aniyah Staton
• Hannah Rose Staton, DPT
• Alayshia Shanta' Steadman-Barr, LMSW, LCSWA

• Internal Medicine Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.