Active NPI
John a Azzato MD PC
- Orthopaedic Surgery Physician
- Southport, NC
National Provider Identifier
1790045409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 20698
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Medical Examiner Physician | 202C00000X | 20698 | NC | |
| Orthopaedic Surgery Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8912440 | Medicaid | NC |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2047392 | John a Azzato, MD | Certificate of waiver | Sep 23, 2026 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Southport, NC
- NPI 1811914435
Independent Medical Examiner
-
- Orthopaedic Surgery Physician
- Southport, NC
- NPI 1497721153
Single Specialty
-
- Physician Assistant
- Wilmington, NC
- NPI 1407862089
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.