First Choice Community Health Centers
Organization Active NPI Family Medicine Physician · Mamers, NC
NPI 1881617850 · NPPES record last updated May 3, 2018
Key facts
- NPI
- 1881617850
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- FIRST CHOICE COMMUNITY HEALTH CENTERS
- Practice address
- 1000 Medical Center Road
Mamers, NC 27552-0397 - Phone
- (910) 893-3063
- Fax
- (910) 897-2567
- NPI assigned
- Jul 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Sheila L Simmons
- Title
- Ceo
- Phone
- (910) 364-0971
Other NPIs on the same Medicare enrollment 4
Practitioners 5
-
Amrit K Gill, MD
-
Marvin Lewis, MD
-
Jaimita V Patel, M.D.
-
Jiho Choi, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040908001617 | NC | Part B Supplier - Clinic/Group Practice | 0941276133 |
Receives reassigned benefits from 10 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lillington, NC |
National Provider Directory
Locations
985 NC Highway 87 S
Cameron, NC 28326
Phone (919) 499-9422
985 NC Highway 87 S
#4382
Cameron, NC 28326
Logistics St M4861
Fort Bragg, NC 28310
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1000 Medical Center Road
Mamers, NC 27552-0397
Mailing address
40 Autumn Fern TRL
Lillington, NC 27546-5155
Phone (910) 364-0971
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 344509A | Medicaid | NC | |
| 2804129 | Other | NC | MEDICARE PART B |
Other names
- Boone Trail Medical Center
Other providers in Mamers, NC
- Leslie Byrne
- First Choice Community Health Centers
- First Choice Community Health Centers
- Marva B Rich
- Joseph Jack Umesi
All providers in Mamers, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.