Individual provider Active NPI

Michael A Williamson

  • Family Nurse Practitioner
  • Pinehurst, NC
National Provider Identifier
1770091571
Registry record updated Jan 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5010167 Issued in NC
Practice address
15 Regional Dr
Pinehurst, NC 28374-8850
Phone
(910) 295-5511
Fax
(910) 235-3432
NPI assigned
Jan 15, 2018
Last updated
Jan 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5010167 NC Primary

Addresses

Primary practice location

15 Regional Dr
Pinehurst, NC 28374-8850

Mailing address

205 Page Rd
Pinehurst, NC 28374-8749
Phone (910) 295-5511

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180316002137 NC Practitioner - Nurse Practitioner 3870855505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1690 US Hwy 1 S
Suite 200
Southern Pines, NC 28387-7037

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.84 of 100Reported as group
Quality
79.14
Promoting interoperability
92
Improvement activities
40
Cost
80.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5010167NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Medical Clinic, Inc. CurrentSince Jan 24, 2018 Accepting new patients
FHPG, LLC Current Accepting new patients
Pinehurst Medical Clinic, Inc. CurrentSince Jan 24, 2018 Accepting new patients
FHPG, LLC CurrentSince Jan 23, 2023 Accepting new patients
FHPG, LLC CurrentSince Jan 23, 2023 Accepting new patients
FHPG, LLC Past Accepting new patients
Pinehurst Medical Clinic, Inc. Past Accepting new patients

Locations

104 Professional Dr
Biscoe, NC 27209
Phone (910) 428-1544

210 E Main St
Candor, NC 27229
Phone (910) 974-3116

1001 Monroe St
Ste D
Carthage, NC 28327
Phone (910) 947-3521

304 E Saunders St
Carthage, NC 28327
Phone (910) 947-3000

112 E Ballard St
Ellerbe, NC 28338
Phone (910) 652-2663

15 Regional Dr
Pinehurst, NC 28374
Phone (910) 255-4400

150 Ivey Ln
Ste B
Pinehurst, NC 28374
Phone (910) 215-5210

205 Page Rd
Pinehurst, NC 28374
Phone (910) 295-9211

313 Teal Dr
Raeford, NC 28376
Phone (910) 904-2350

300 S Middleton St
Robbins, NC 27325
Phone (910) 948-2911

104 Physicians Park Dr
Rockingham, NC 28379
Phone (910) 895-1989

921 S Long Dr
Ste 101
Rockingham, NC 28379
Phone (910) 417-3850

3110 S Horner Blvd
Sanford, NC 27332
Phone (910) 295-4400

1690 US Highway 1 S
Ste 200
Southern Pines, NC 28387
Phone (910) 684-5159

3349 US 1 Hwy
Vass, NC 28394
Phone (910) 245-7678

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1515974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515974400000",
    "number": "1770091571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PAGE RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748749",
            "telephone_number": "910-295-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REGIONAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748850",
            "telephone_number": "910-295-5511",
            "fax_number": "910-235-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-15",
        "last_updated": "2018-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.