NPIMap

Organization Active NPI

Raleigh Durham Medical Group PA

Doing business as North Raleigh Primary Care

  • Family Medicine Physician
  • Raleigh, NC
National Provider Identifier
1801848049
Registry record updated Mar 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RALEIGH DURHAM MEDICAL GROUP PA
Doing business as
North Raleigh Primary Care
Practice address
4905 Green Rd
Ste 100
Raleigh, NC 27616-2805
Phone
(919) 872-5411
Fax
(919) 872-5904
NPI assigned
May 16, 2006
Last updated
Mar 5, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
RALEIGH DURHAM MEDICAL GROUP PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2009

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

Authorized official

Name
David K Moye
Title
Senior Vice President
Phone
(919) 851-2174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4905 Green Rd
Ste 100
Raleigh, NC 27616-2805

Mailing address

5420 Wade Park Blvd
Ste 106
Raleigh, NC 27607-4188
Phone (919) 851-2174

Other identifiers 2

IdentifierTypeStateIssuer
0237VOtherNCBCBS
5900361MedicaidNC

Other names 1

  • North Raleigh Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041220000155 NC Part B Supplier - Clinic/Group Practice 2365409588 Receives reassigned benefits from 103 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greensboro, NC; Four Oaks, NC; Greenville, NC; Morrisville, NC; Raleigh, NC; Wake Forest, NC; Cary, NC; Fayetteville, NC…

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
McCrimmon Primary Care Plus

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236211200000",
    "number": "1801848049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 WADE PARK BLVD",
            "address_2": "STE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276074188",
            "telephone_number": "919-851-2174",
            "fax_number": "919-854-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 GREEN RD",
            "address_2": "STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162805",
            "telephone_number": "919-872-5411",
            "fax_number": "919-872-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH DURHAM MEDICAL GROUP PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RALEIGH DURHAM MEDICAL GROUP PA",
        "enumeration_date": "2006-05-16",
        "last_updated": "2009-03-05",
        "status": "A",
        "authorized_official_last_name": "MOYE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "919-851-2174"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0237V",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900361",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Raleigh Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.