Organization Active NPI

Cumberland Medical Associates, PC

  • Internal Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1801945118
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CUMBERLAND MEDICAL ASSOCIATES, PC
Practice address
5085 Morganton Rd
Suite 100
Fayetteville, NC 28314-1523
Phone
(910) 864-0689
Fax
(910) 864-3747
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Authorized official

Name
Dr. Sanjiv S Dalvi, M.D.NPI 1881763944
Title
Owner
Phone
(910) 864-0689

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

5085 Morganton Rd
Suite 100
Fayetteville, NC 28314-1523

Mailing address

5085 Morganton Rd
Suite 100
Fayetteville, NC 28314-1523
Phone (910) 864-0689

Other identifiers 1

IdentifierTypeStateIssuer
89014WWMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031103000151 NC Part B Supplier - Clinic/Group Practice 6608788336 Receives reassigned benefits from 4 practitioners
Practice locations: Fayetteville, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1801945118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5085 MORGANTON RD",
            "address_2": "SUITE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141523",
            "telephone_number": "910-864-0689",
            "fax_number": "910-864-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5085 MORGANTON RD",
            "address_2": "SUITE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141523",
            "telephone_number": "910-864-0689",
            "fax_number": "910-864-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "DALVI",
        "authorized_official_first_name": "SANJIV",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-864-0689",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89014WW",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.