Mid Carolina Gastroenterology Associates, PA

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

Legal business name

MID CAROLINA GASTROENTEROLOGY ASSOCIATES, PA

Practice address

110 Dennis Dr
Sanford, NC 27330-6343

Phone

(919) 774-4511

Fax

(919) 774-3196

NPI assigned

Apr 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Marion B. Pate III, MD

Title

President

Phone

(919) 774-4511

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1922061902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 DENNIS DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273306343",
            "telephone_number": "919-774-4511",
            "fax_number": "919-774-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DENNIS DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273306343",
            "telephone_number": "919-774-4511",
            "fax_number": "919-774-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID CAROLINA GASTROENTEROLOGY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "PATE",
        "authorized_official_first_name": "MARION",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-774-4511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "0195A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890195A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Keith Merritt, M.D.
• Natalie Mial
• Michael C. Hattaway
• Michelle F. Moseley, LPC, PLLC
• Mid Carolina Gastroenterology Associates, PA
• Mid Carolina Primary Care, PA
• Mid Carolina Radiology Associates PA
• Mid Carolina Surgical Clinic PA
• Millenium IV, Inc.
• Millenium IV, Inc.

• All providers in Sanford, NC
• Endoscopy Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.