NPIMap

Organization Active NPI

Wrightsboro Family Practice and Urgent Care LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Wilmington, NC
National Provider Identifier
1962456145
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
WRIGHTSBORO FAMILY PRACTICE AND URGENT CARE LLC
Practice address
2539 Castle Hayne Rd
Ste F1
Wilmington, NC 28401-2691
Phone
(910) 392-7064
Fax
(910) 392-5885
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Authorized official

Name
James Jerome Pence Jr., MD
Title
President
Phone
(910) 392-7064

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X Primary

Addresses

Primary practice location

2539 Castle Hayne Rd
Ste F1
Wilmington, NC 28401-2691

Mailing address

2539 Castle Hayne Rd
Ste F1
Wilmington, NC 28401-2691
Phone (910) 392-7064

Other identifiers 1

IdentifierTypeStateIssuer
5903744MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1962456145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 CASTLE HAYNE RD",
            "address_2": "STE F1",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284012691",
            "telephone_number": "910-392-7064",
            "fax_number": "910-392-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 CASTLE HAYNE RD",
            "address_2": "STE F1",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284012691",
            "telephone_number": "910-392-7064",
            "fax_number": "910-392-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WRIGHTSBORO FAMILY PRACTICE AND URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "PENCE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-392-7064",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5903744",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.