John Michael Neidecker, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

207Q00000X Issued in NJ

Practice address

11200 Governor Manly Way Ste 309
Raleigh, NC 27614-7375

Phone

(919) 562-9410

Fax

(919) 562-2948

NPI assigned

Aug 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Sports MedicineAlso: Family Practice

Education

Rutgers School of Dental Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedic Specialists of North Carolina, P.a.Group PAC ID 7810974375, 49 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.06 of 100Reported as group

Quality

61.01

Promoting interoperability

100

Improvement activities

40

Cost

82.52

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.neidecker.1@12529.direct.athenahealth.com

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.

• Orthopaedic Specialists of North Carolina, P.a.

  • Orthopaedic Surgery Physician
  • Raleigh, NC
  • NPI 1649327750
  Medicare reassignment Care Compare group NPD
• Orthopaedic Specialists of North Carolina, P.a.

  • Orthopaedic Surgery Physician
  • Raleigh, NC
  • NPI 1447553870
  NPD

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1821289174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275881107",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 GOVERNOR MANLY WAY STE 309",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147375",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Parkview Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NC",
            "postal_code": "275365958",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 Professional Park Ste A",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "NC",
            "postal_code": "275652581",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2605 Blue Ridge Rd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276076475",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6602 Knightdale Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Knightdale",
            "state": "NC",
            "postal_code": "275456526",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-2948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEIDECKER",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "207Q00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MB08631900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nehemiah-Joseph Logistics Services LLC
• Madison Lin Nehlen, PT, DPT
• Constance Buell Nehls, MS, PT, CLT
• Kyra Laine Nehls
• Angelina Neiberger
• Bailey Neighbor
• Neighborhealth Center, Inc.
• Neighborhealth Center, Inc.
• Neighborhealth Centers LLC
• Joseph D. Neighbors Jr., M.D.

• Family Medicine Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.