Active NPI
MCPC-25 LLC
- Radiation Oncology Physician
- Pinehurst, NC
National Provider Identifier
1821789322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- Legal business name
- MCPC-25 LLC
- Practice address
- 135 Page Rd N
Pinehurst, NC 28374-4607 - Phone
- (910) 715-1056
- Fax
- (910) 715-1060
- NPI assigned
- May 16, 2023
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | Primary |
Addresses
Primary practice location
135 Page Rd N
Pinehurst, NC 28374-4607
Mailing address
135 Page Rd N
Pinehurst, NC 28374-4607
Phone (910) 715-1056
Other names 1
- FirstHealth Radiation Oncology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230831004178 | NC | Part B Supplier - Clinic/Group Practice | 2860855210 |
Receives reassigned benefits from 5 practitioners Practice locations: Pinehurst, NC |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the 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.
-
- Radiation Oncology Physician
- Pinehurst, NC
- NPI 1013916543
NC, Radiation Oncology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684195200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1735603200000",
"number": "1821789322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 PAGE RD N",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283744607",
"telephone_number": "910-715-1056",
"fax_number": "910-715-1060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 PAGE RD N",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283744607",
"telephone_number": "910-715-1056",
"fax_number": "910-715-1060"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCPC-25 LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-05-16",
"last_updated": "2024-12-31",
"certification_date": "2024-12-31",
"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": "2085R0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Radiation Oncology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "FirstHealth Radiation Oncology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Pinehurst, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.