Individual provider Active NPI

David Donald Fraser, MD

  • Rheumatology Physician
  • Jacksonville, NC
National Provider Identifier
1992794614
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
31985 Issued in NC
Practice address
1126B Kellum Loop Rd
Jacksonville, NC 28546-3304
Phone
(910) 577-0177
Fax
(910) 577-0183
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 31985 NC Primary

Addresses

Primary practice location

1126B Kellum Loop Rd
Jacksonville, NC 28546-3304

Mailing address

1126B Kellum Loop Rd
Jacksonville, NC 28546-3304
Phone (910) 577-0177

Other identifiers 1

IdentifierTypeStateIssuer
8933694MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100903000266 NC Practitioner - RheumatologyPractitioner - Internal Medicine 6800890104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
29.84 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
99.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31985NCMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Arthritis and Rheumatism Associates PA Rheumatology CurrentSince Nov 9, 1999 Accepting new patients

Locations

1126B Kellum Loop Rd
Jacksonville, NC 28546
Phone (910) 577-0177

1126 Kellum Loop Rd
#B
Jacksonville, NC 28546
Phone (910) 577-0177

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1992794614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126B KELLUM LOOP RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285463304",
            "telephone_number": "910-577-0177",
            "fax_number": "910-577-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126B KELLUM LOOP RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285463304",
            "telephone_number": "910-577-0177",
            "fax_number": "910-577-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "DAVID",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NC",
            "license": "31985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8933694",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.