Active NPI
Ian Williamson Staten, M.D.
- Emergency Medicine Physician
- Fort Bragg, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 2019-01755
- Practice address
- 2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001 - Phone
- (910) 907-8922
- Fax
- (910) 907-6069
- NPI assigned
- May 12, 2016
- Last updated
- Feb 18, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 2019-01755 | NC | Primary |
Addresses
Primary practice location
2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Mailing address
2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Phone (910) 907-8922
Other practice location 1
2300 Ramsey St
Fayetteville, NC 28301-3856
Phone (910) 488-2120
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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 82.58 of 100
- Quality
- 75.66
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vidant Medical Group LLC | Current | Accepting new patients | |
| Emergency Coverage, LLC | Emergency Medicine | Current | Accepting new patients |
Locations
2700 Wayne Memorial Dr
Goldsboro, NC 27534
Phone (919) 731-6060
2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229
401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941
615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699
628 E 12th St
Washington, NC 27889
Phone (252) 975-4100
Interoperability endpoints
- istaten499673@direct.unc.nchie.net
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Greenville, NC
- NPI 1477648731
-
dba Emergency Coverage Corporation of TeamHealth
- Family Medicine Physician
- Newport, TN
- NPI 1427005008
Emergency Medicine, NC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771372800000",
"number": "1780030437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2817 ROCK MERRITT AVE",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-8922",
"fax_number": "910-907-6069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2817 ROCK MERRITT AVE",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "910-907-8922",
"fax_number": "910-907-6069"
}
],
"practiceLocations": [
{
"address_1": "2300 Ramsey St",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "NC",
"postal_code": "283013856",
"country_code": "US",
"telephone_number": "910-488-2120",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STATEN",
"first_name": "IAN",
"middle_name": "WILLIAMSON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-12",
"last_updated": "2026-02-18",
"certification_date": "2026-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NC",
"license": "2019-01755",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Bragg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.