Ferncreek Primary Care, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

FERNCREEK PRIMARY CARE, PC

Practice address

1314 Medical Dr Ste 102
Fayetteville, NC 28304

Phone

(910) 491-3922

Fax

(910) 491-5350

NPI assigned

Aug 12, 2015

Last updated

May 24, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pravinkumar K Patel, MDNPI 1669449179

Title

President

Phone

(910) 491-3922

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pravinkumar Kantilal Patel, MD

  • Internal Medicine Physician
  • Fayetteville, NC
  • NPI 1669449179
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527120000000",
    "number": "1992171078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 MEDICAL DR STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044421",
            "telephone_number": "910-491-3922",
            "fax_number": "910-491-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 MEDICAL DR STE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-491-3922",
            "fax_number": "910-491-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERNCREEK PRIMARY CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-12",
        "last_updated": "2018-05-24",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PRAVINKUMAR",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-491-3922",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharonda Nisha Ferguson, LCMHC,BCBA,LBA
• Kathryn Fernandez-Shapiro
• Annette Maria Fernandez, M.ED
• Gabriel I Fernandez, MD
• Ferncreek Cardiology PA
• Kenneth Ferrato, MD
• Mark Jordan Ferrell
• Jessica Elizabeth Ferrence, LCMHC, NCC
• Dianna Nichole Ferro, PT, DPT
• Sarah Ferry

• Internal Medicine Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.