Organization Active NPI

John a Azzato MD PC

  • Orthopaedic Surgery Physician
  • Southport, NC
National Provider Identifier
1790045409
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
20698 Issued in NC
Legal business name
JOHN A AZZATO MD PC
Practice address
1513 N Howe St
Suite 4
Southport, NC 28461-2769
Phone
(910) 805-5578
NPI assigned
May 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Authorized official

Name
Jean Phillips
Title
Office Manager
Phone
(910) 805-5578

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202C00000X 20698 NC
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 20698 NC Primary

Addresses

Primary practice location

1513 N Howe St
Suite 4
Southport, NC 28461-2769

Mailing address

PO Box 11505
Southport, NC 28461-1505
Phone (910) 805-5578

Other identifiers 1

IdentifierTypeStateIssuer
8912440MedicaidNC

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2047392John a Azzato, MD1513 N Howe Street, Suite 4, Southport, NC 28461Certificate of waiverSep 23, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358294400000",
    "number": "1790045409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11505",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284611505",
            "telephone_number": "910-805-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 N HOWE ST",
            "address_2": "SUITE 4",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284612769",
            "telephone_number": "910-805-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A AZZATO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2013-01-16",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-805-5578"
    },
    "taxonomies": [
        {
            "code": "202C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Independent Medical Examiner",
            "state": "NC",
            "license": "20698",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "20698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912440",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.