Individual provider Active NPI

Jeffrey Haskell Fair, MD

  • Surgery Physician
  • Whiteville, NC
National Provider Identifier
1780606004
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
29106 Issued in NC
Practice address
508 Jefferson St
Whiteville, NC 28472-3634
Phone
(910) 640-2480
Fax
(910) 640-2487
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME111974 FL
Surgical Critical Care Physician 2086S0102X R4219 TX
Surgery Physician 208600000X 29106 NC Primary

Addresses

Primary practice location

508 Jefferson St
Whiteville, NC 28472-3634

Mailing address

1213 Olmstead LN
Wilmington, NC 28405-4199
Phone (352) 586-1059

Other identifiers 2

IdentifierTypeStateIssuer
004578500MedicaidFL
8931062MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051012000167 NC Practitioner - General Surgery 0446275143 Reassigns benefits to 1 organization
I20160107001185 TX Practitioner - General Surgery 0446275143 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Brody School of Medicine at East Carolina University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Surgical PAGroup PAC ID 9234415498, 2 clinicians

Practice addresses (Care Compare)

508 Jefferson St
Whiteville, NC 28472-3634
Phone (910) 640-2480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue16
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME111974FLMDSurgery Physician
29106NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Surgery CurrentSince Sep 1, 2022 Accepting new patients
Utmb Faculty Group Practice Surgery CurrentSince Jan 1, 2016 Accepting new patients
East Carolina Surgical, P.a. Surgery CurrentSince Mar 1, 2025 Accepting new patients
Ut Physicians CurrentSince Sep 1, 2022 Accepting new patients

Locations

508 Jefferson St
Whiteville, NC 28472
Phone (910) 640-2480

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

6411 Fannin St
#J1400
Houston, TX 77030
Phone (713) 704-5200

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

1048 Terrace Dr
Marion, VA 24354
Phone (276) 228-2212

Interoperability endpoints

  • Direct secure messaging: jfairmd32022@direct.utmb.edu

Organizations & group practices 4

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 1

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1780606004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 OLMSTEAD LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284054199",
            "telephone_number": "352-586-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723634",
            "telephone_number": "910-640-2480",
            "fax_number": "910-640-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "JEFFREY",
        "middle_name": "HASKELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME111974",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "R4219",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "29106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004578500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8931062",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

Verify at the official NPI Registry.