NPIMap

Organization Active NPI

Methodist University

  • Medical Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1962809269
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
103047 Issued in NC
Legal business name
METHODIST UNIVERSITY
Practice address
5400 Ramsey St
Fayetteville, NC 28311-1420
Phone
(910) 630-7164
Fax
(910) 630-7544
NPI assigned
Dec 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Authorized official

Name
Dr. Ben Hancock
Title
President
Phone
(910) 630-7164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X 103047 NC Primary

Addresses

Primary practice location

5400 Ramsey St
Fayetteville, NC 28311-1420

Mailing address

5400 Ramsey St
Fayetteville, NC 28311-1420
Phone (910) 630-7164

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
34D2161718Methodist University Health Center5400 Ramsey Street, Fayetteville, NC 28311Certificate of waiverFeb 7, 2027

National Provider Directory

National Provider Directory

Locations

5400 Ramsey St
Fayetteville, NC 28311
Phone (910) 630-7000

Practitioners & affiliated clinicians

Practitioners 6

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": "1417478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1962809269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111420",
            "telephone_number": "910-630-7164",
            "fax_number": "910-630-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111420",
            "telephone_number": "910-630-7164",
            "fax_number": "910-630-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-02",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-630-7164",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.