Ware Family Medicine PLLC
Organization Active NPI Family Medicine Physician · Old Fort, NC
NPI 1922601764 · NPPES record last updated Jan 28, 2022
Key facts
- NPI
- 1922601764
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- WARE FAMILY MEDICINE PLLC
- Practice address
- 32 E Main St
Old Fort, NC 28762-0017 - Phone
- (828) 668-6435
- Fax
- (833) 913-2496
- NPI assigned
- Nov 16, 2020
- Organization subpart
- No
Authorized official
- Name
- Brian M Ware, DO
- Title
- Sole Member
- Phone
- (828) 668-6435
Practitioners 5
-
Brian Michael Ware, D.O.
-
Darus Clyde Henson, FNP-C
-
Anna Shtymak, PA
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2228909 | Ware Family Medicine, PLLC | Certificate of waiver | Jul 1, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201202001814 | NC | Part B Supplier - Clinic/Group Practice | 2567873177 |
Receives reassigned benefits from 5 practitioners Practice locations: Old Fort, NC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
32 E Main St
Old Fort, NC 28762-0017
Mailing address
32 E Main St
Old Fort, NC 28762-0017
Phone (828) 668-6435
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | brian.ware.1@23581.direct.athenahealth.com |
Other providers in Old Fort, NC
- Suws of the Carolinas
- Suws of the Carolinas
- The McDowell Hospital Inc
- Jon Charles Tripp
- Kevin Waller
- Brian Michael Ware
- Wings of Flight Center for Change, PLLC
All providers in Old Fort, 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 Jan 28, 2022. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.