Organization Active NPI

Regional Diabetes and Endocrine Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Fayetteville, NC
National Provider Identifier
1962404384
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
REGIONAL DIABETES AND ENDOCRINE CENTER
Practice address
101 Robeson St Ste 405
Fayetteville, NC 28301-5520
Phone
(910) 615-1623
Fax
(910) 321-6248
NPI assigned
Aug 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Joseph Barton Fiser
Title
VP Corporate Reveune Cycle
Phone
(910) 615-5572

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

101 Robeson St Ste 405
Fayetteville, NC 28301-5520

Mailing address

PO Box 40908
Fayetteville, NC 28309-0908
Phone (910) 615-6448

Other identifiers 1

IdentifierTypeStateIssuer
89104URMedicaidNC

Other names 1

  • Diabetes and Endocrine Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050524000145 NC Part B Supplier - Clinic/Group Practice 5092701771 Receives reassigned benefits from 3 practitioners
Practice locations: Fayetteville, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1015049Regional Diabetes & Endocrine Center, the101 Robeson Street, Suite 405, Fayetteville, NC 28301Certificate of waiverJul 21, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1962404384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40908",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283090908",
            "telephone_number": "910-615-6448",
            "fax_number": "910-615-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ROBESON ST STE 405",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015520",
            "telephone_number": "910-615-1623",
            "fax_number": "910-321-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL DIABETES AND ENDOCRINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "FISER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "BARTON",
        "authorized_official_title_or_position": "VP CORPORATE REVEUNE CYCLE",
        "authorized_official_telephone_number": "910-615-5572"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89104UR",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetes and Endocrine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.