Active NPI
Hope Medical Clinic PA
- Internal Medicine Physician
- Fayetteville, NC
National Provider Identifier
1982270567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- HOPE MEDICAL CLINIC PA
- Practice address
- 3609 Cape Center Dr
Fayetteville, NC 28304-4457 - Phone
- (910) 500-0909
- Fax
- (910) 920-4224
- NPI assigned
- Jun 3, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Hanna Z Iyasu
- Title
- Chief Finance Officer
- Phone
- (910) 500-0909
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
3609 Cape Center Dr
Fayetteville, NC 28304-4457
Mailing address
3609 Cape Center Dr
Fayetteville, NC 28304-4457
Phone (910) 500-0909
Other names 1
- Hope Medical Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2229179 | Hope Medical Clinic, PA | Certificate of waiver | Jul 7, 2027 |
National Provider Directory
National Provider DirectoryLocations
3609 Cape Center Dr
Fayetteville, NC 28304
Phone (910) 323-5322
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DBJCDD
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Fayetteville, NC
- NPI 1518235431
-
- Primary Care Nurse Practitioner
- Fayetteville, NC
- NPI 1932919644
-
- Obstetrics & Gynecology Physician
- Fayetteville, NC
- NPI 1316033368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622678400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1701734400000",
"number": "1982270567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3609 CAPE CENTER DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283044457",
"telephone_number": "910-500-0909",
"fax_number": "910-920-4224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3609 CAPE CENTER DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283044457",
"telephone_number": "910-500-0909",
"fax_number": "910-920-4224"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOPE MEDICAL CLINIC PA",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-03",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A",
"authorized_official_last_name": "IYASU",
"authorized_official_first_name": "HANNA",
"authorized_official_middle_name": "Z",
"authorized_official_title_or_position": "CHIEF FINANCE OFFICER",
"authorized_official_telephone_number": "910-500-0909"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Hope Medical Clinic",
"code": "5",
"type": "Other Name"
}
]
}
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 5, 2023; 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.