Active NPI
Gustavo Ivan Cadavid, D.O
- Psychiatry Physician
- Fort Bragg, NC
National Provider Identifier
1952546293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- OS 6548
- Practice address
- Wamc, 2817 Rielly Rd
Box 85
Fort Bragg, NC 28310-0001 - Phone
- (786) 489-0165
- NPI assigned
- Dec 15, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | OS 6548 | FL | Primary |
Addresses
Primary practice location
Wamc, 2817 Rielly Rd
Box 85
Fort Bragg, NC 28310-0001
Mailing address
Wamc, 2817 Rielly Rd
Box 85
Fort Bragg, NC 28310-0001
Phone (786) 489-0165
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS 6548 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229299200000",
"number": "1952546293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "WAMC, 2817 RIELLY RD",
"address_2": "BOX 85",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "786-489-0165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WAMC, 2817 RIELLY RD",
"address_2": "BOX 85",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283100001",
"telephone_number": "786-489-0165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CADAVID",
"first_name": "GUSTAVO",
"middle_name": "IVAN",
"name_prefix": "Dr.",
"credential": "D.O",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-15",
"last_updated": "2008-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "OS 6548",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bragg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.