NPIMap

Organization Active NPI

MCPC-22, LLC

  • Specialist
  • Fayetteville, NC
National Provider Identifier
1821787151
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MCPC-22, LLC
Practice address
3716 Morganton Rd
Fayetteville, NC 28303-4963
Phone
(910) 565-5155
Fax
(910) 235-0546
NPI assigned
May 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Authorized official

Name
Mickey Foster
Title
Ceo
Phone
(910) 715-4473

Specialties & licenses 1

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

Addresses

Primary practice location

3716 Morganton Rd
Fayetteville, NC 28303-4963

Mailing address

3716 Morganton Rd
Fayetteville, NC 28303-4963
Phone (910) 565-5155

Other practice location 1

40 Ramseur Rd Ste 102
Pittsboro, NC 27312-1895
Phone (919) 726-4710

Other names 1

  • FirstHealth Neurology - Fayetteville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211230001544 NC Part B Supplier - Clinic/Group Practice 7315338324 Receives reassigned benefits from 14 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pinehurst, NC; Troy, NC; Sanford, NC; Pittsboro, NC; Fayetteville, NC; Cary, NC

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Firsthealth - Sandhills Neurologists2 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.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

295 Olmsted Blvd
Pinehurst, NC 28374
Phone (910) 375-7344

Practitioners & affiliated clinicians

Practitioners 6

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": "1683072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1821787151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 MORGANTON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034963",
            "telephone_number": "910-565-5155",
            "fax_number": "910-235-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 MORGANTON RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034963",
            "telephone_number": "910-565-5155",
            "fax_number": "910-235-0546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Ramseur Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Pittsboro",
            "state": "NC",
            "postal_code": "273121895",
            "country_code": "US",
            "telephone_number": "919-726-4710",
            "fax_number": "910-235-0546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MCPC-22, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-03",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-715-4473"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FirstHealth Neurology - Fayetteville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FirstHealth Neurology - Fayetteville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 30, 2024; 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.