Organization Active NPI

Cardinal Clinic LLC

  • Community/Behavioral Health Agency
  • Southern Pines, NC
National Provider Identifier
1932263720
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CARDINAL CLINIC LLC
Practice address
160 Pinehurst Ave Ste J
Southern Pines, NC 28387-7078
Phone
(910) 693-7777
Fax
(910) 693-1524
NPI assigned
Dec 19, 2006
Last updated
May 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Authorized official

Name
Tony Garcia
Title
QM Coordinator
Phone
(910) 864-0187

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

160 Pinehurst Ave Ste J
Southern Pines, NC 28387-7078

Mailing address

1540 Purdue Dr Ste 200
Fayetteville, NC 28303-5510
Phone (910) 867-8889

Other identifiers 1

IdentifierTypeStateIssuer
8300367MedicaidNC

National Provider Directory

National Provider Directory

Locations

160 Pinehurst Ave
Ste J
Southern Pines, NC 28387
Phone (910) 693-7777

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1932263720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 PURDUE DR STE 200",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035510",
            "telephone_number": "910-867-8889",
            "fax_number": "910-487-3061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 PINEHURST AVE STE J",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283877078",
            "telephone_number": "910-693-7777",
            "fax_number": "910-693-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "QM COORDINATOR",
        "authorized_official_telephone_number": "910-864-0187"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300367",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southern Pines, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.