Organization Active NPI

Hope Medical Clinic PA

  • Internal Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1982270567
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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

Updated by the provider on Dec 5, 2023

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210809003216 NC Part B Supplier - Clinic/Group Practice 9638573934 Receives reassigned benefits from 2 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
34D2229179Hope Medical Clinic, PA3609 Cape Center Drive, Fayetteville, NC 28304Certificate of waiverJul 7, 2027

National Provider Directory

National Provider Directory

Locations

3609 Cape Center Dr
Fayetteville, NC 28304
Phone (910) 323-5322

Interoperability endpoints

  • FHIR API: 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.

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.

Verify at the official NPI Registry.