Highland Family Practice PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

39456 Issued in NC

Legal business name

HIGHLAND FAMILY PRACTICE PA

Practice address

1248 Fort Bragg Rd
Fayetteville, NC 28305-4728

Phone

(910) 323-0334

Fax

(888) 391-5874

NPI assigned

Oct 3, 2005

Organization subpart

No

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

Authorized official

Name

Dr. George Constantine Pantelakos, MD

Title

MD Owner

Phone

(910) 323-0334

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1891782033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1248 FORT BRAGG RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283054728",
            "telephone_number": "910-323-0334",
            "fax_number": "888-391-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 FORT BRAGG RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283054728",
            "telephone_number": "910-323-0334",
            "fax_number": "888-391-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "PANTELAKOS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "CONSTANTINE",
        "authorized_official_title_or_position": "MD OWNER",
        "authorized_official_telephone_number": "910-323-0334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "39456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "896518E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lillian Higginbotham
• Higgins, Mani & Watson III DDS PA
• High Quality Personal Care Service
• Sue S High, FNP-BC
• Highland Clinic
• Highland Health of North Carolina PA
• Highland House of Fayetteville, Inc
• Highland Neurology Center PA
• Highland OB/GYN Clinic, PA
• Highland OB/GYN Clinic, PA

• Family Medicine Physician in Fayetteville, NC
• Providers in Fayetteville, 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 Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.