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MASONBORO FAMILY MEDICINE P.C. NPI 1417018565


NPI Information

NPI: 1417018565
Provider Name: MASONBORO FAMILY MEDICINE, P.C.
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization

CLIA Number: 34D1017476

Address:
6419 CAROLINA BEACH ROAD
SUITE A
WILMINGTON, NC
ZIP 28412
Phone: (910) 790-3660
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MASONBORO FAMILY MEDICINE, P.C. is a preferred provider organization in Wilmington, NC. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. MASONBORO FAMILY MEDICINE, P.C. NPI is 1417018565. The provider is registered as an organization entity type.

The provider's business location address is:

6419 CAROLINA BEACH ROAD
SUITE A
WILMINGTON, NC
ZIP 28412-788
Phone: (910) 790-3660

The provider's authorized official is Erin Carter .
The authorized official title is Billing Office and has the following contact phone number (910) 790-3660.

The CLIA number assigned to this NPI record is 34D1017476 - practitioner other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/13/2006 and was last updated on 1/3/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305R00000XPreferred Provider OrganizationYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F36078MEDICARE UPINNORTH CAROLINA
2E21368MEDICARE UPIN
3015C3MEDICAIDNORTH CAROLINA
42192374BMEDICARE PIN
51022110001MEDICARE PINNORTH CAROLINA
687545OTHERNORTH CAROLINABCBS
718265OTHERNORTH CAROLINABCBS
8G06165MEDICARE UPINNORTH CAROLINA
98910892MEDICAIDNORTH CAROLINA
10S62999MEDICARE UPINNORTH CAROLINA
11051C3OTHERNORTH CAROLINABCBS
12201605BMEDICARE PINNORTH CAROLINA
13S83378MEDICARE UPINNORTH CAROLINA
142335346MEDICARE PIN
1510892OTHERNORTH CAROLINABCBS NC
161022110001MEDICARE NSCNORTH CAROLINA
178961634MEDICAIDNORTH CAROLINA
1861634OTHERNORTH CAROLINABCBS
19C85249MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.