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FAYETTEVILLE ORTHOPAEDIC CLINIC PA NPI 1417919390


NPI Information

NPI: 1417919390
Provider Name: FAYETTEVILLE ORTHOPAEDIC CLINIC, PA

Doing Business As: FAYETTEVILLE ORTHOPAEDICS AND SPORTS MEDICINE

Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
1991 FORDHAM DR
SUITE 100
FAYETTEVILLE, NC
ZIP 28304
Phone: (910) 484-3114
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FAYETTEVILLE ORTHOPAEDIC CLINIC, PA is an orthopaedic surgery in Fayetteville, NC. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. FAYETTEVILLE ORTHOPAEDIC CLINIC, PA NPI is 1417919390. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Fayetteville Orthopaedics And Sports Medicine.

The provider's business location address is:

1991 FORDHAM DR
SUITE 100
FAYETTEVILLE, NC
ZIP 28304-650
Phone: (910) 484-3114
Fax: (910) 484-8824

The provider's authorized official is James Erwin Johnson .
The authorized official title is Practice Administrator and has the following contact phone number (910) 223-2007.

The enumeration date for this NPI number is 4/5/2006 and was last updated on 5/4/2012.


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
1207X00000XOrthopaedic SurgeryNORTH CAROLINAYes

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
18901555MEDICAIDNORTH CAROLINA
20295MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
30314090001MEDICARE NSCNORTH CAROLINA

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

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