NPIMap

Individual provider Active NPI

Michael J Fedewa Jr., DO

  • Family Medicine Physician
  • Cherry Point, NC
National Provider Identifier
1881956530
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2013-01911 Issued in NC
Practice address
4389 Beaufort Rd
Naval Health Clinic
Cherry Point, NC 28533-2100
Phone
(910) 450-4159
Fax
(910) 450-4194
NPI assigned
Jun 8, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 2013-01911 NC Primary

Addresses

Primary practice location

4389 Beaufort Rd
Naval Health Clinic
Cherry Point, NC 28533-2100

Mailing address

100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190911001157 NC Practitioner - Family Practice 0941439269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

100 Duke Health Cary PL
Suite 110
Cary, NC 27519-6760
Phone (919) 385-4855

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

351 Wellesley Trade LN
Suite 100
Cary, NC 27519-5669
Phone (919) 576-8100

401 Irving Pkwy
Holly Springs, NC 27540-5301

7200 Creedmoor Rd
Suite 208
Raleigh, NC 27613-1711
Phone (919) 327-1650

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Aug 5, 2019 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine CurrentSince Aug 5, 2019 Accepting new patients
Duke University Affiliated Physicians, Inc. Family Medicine Current Accepting new patients

Locations

540 New Waverly Pl
Ste 200
Cary, NC 27518
Phone (919) 324-3026

100 Duke Health Cary Pl
Ste 230
Cary, NC 27519
Phone (919) 385-4400

351 Wellesley Trade Ln
Ste 100
Cary, NC 27519
Phone (919) 576-8100

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

5716 Fayetteville Rd
Durham, NC 27713
Phone (919) 572-1862

401 Irving Pkwy
Ste 210
Holly Springs, NC 27540
Phone (919) 385-6700

7200 Creedmoor Rd
Ste 208
Raleigh, NC 27613
Phone (919) 327-1650

10211 Alm St
Ste 1100
Raleigh, NC 27617
Phone (919) 385-1160

7021 Harps Mill Rd
Raleigh, NC 27615
Phone (919) 823-5446

Interoperability endpoints

  • Direct secure messaging: mfedewa427858@direct.medicine.duke.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1881956530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4389 BEAUFORT RD",
            "address_2": "NAVAL HEALTH CLINIC",
            "city": "CHERRY POINT",
            "state": "NC",
            "postal_code": "285332100",
            "telephone_number": "910-450-4159",
            "fax_number": "910-450-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDEWA",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-08",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2013-01911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Point, NC

Sources for this page

Verify at the official NPI Registry.