Organization Active NPI

Raleigh Plastic Surgery Center

  • Specialist
  • Raleigh, NC
National Provider Identifier
1821047648
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
RALEIGH PLASTIC SURGERY CENTER
Practice address
1112 Dresser CT
Raleigh, NC 27609-7303
Phone
(919) 872-2616
Fax
(919) 872-2771
NPI assigned
May 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. William A Lambeth, MD
Title
Ceo
Phone
(919) 872-2616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X NC Primary

Addresses

Primary practice location

1112 Dresser CT
Raleigh, NC 27609-7303

Mailing address

1112 Dresser CT
Raleigh, NC 27609-7303
Phone (919) 872-2616

Other identifiers 1

IdentifierTypeStateIssuer
8902506MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090529000209 NC Part B Supplier - Clinic/Group Practice 4183773864 Receives reassigned benefits from 3 practitioners
Practice locations: Raleigh, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Raleigh Plastic Surgery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1112 Dresser Ct
Raleigh, NC 27609
Phone (919) 872-2616

Practitioners & affiliated clinicians

Practitioners 4

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": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821047648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 DRESSER CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097303",
            "telephone_number": "919-872-2616",
            "fax_number": "919-872-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 DRESSER CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097303",
            "telephone_number": "919-872-2616",
            "fax_number": "919-872-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH PLASTIC SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAMBETH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-872-2616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902506",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.