Individual provider Active NPI

David Peter Fedder, M.D.

  • Orthopaedic Surgery Physician
  • Pinehurst, NC
National Provider Identifier
1790792950
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
00-35119 Issued in NC
Practice address
5 Firstvillage Drive
Pinehurst, NC 28374
Phone
(910) 295-6831
Fax
(910) 295-0244
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 00-35119 NC Primary

Addresses

Primary practice location

5 Firstvillage Drive
Pinehurst, NC 28374

Mailing address

5 First Village Dr
PO Box 2000
Pinehurst, NC 28374-8724
Phone (910) 295-6831

Other identifiers 1

IdentifierTypeStateIssuer
8931471MedicaidNC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100304000721 NC Practitioner - Orthopedic Surgery 0042395733 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00-35119NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCPC-9, LLC Orthopaedic Surgery CurrentSince Mar 1, 2013 Accepting new patients

Locations

5 First Village Dr
Pinehurst, NC 28374
Phone (910) 235-2713

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1790792950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FIRST VILLAGE DR",
            "address_2": "PO BOX 2000",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748724",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FIRSTVILLAGE DRIVE",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDDER",
        "first_name": "DAVID",
        "middle_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "00-35119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8931471",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.