1184394520 NPI number — GENERATIONS FAMILY PRACTICE, PA

Table of content: DR. KARYL COOPER PATTEN D.D.S, MPH (NPI 1922153600)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184394520 NPI number — GENERATIONS FAMILY PRACTICE, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GENERATIONS FAMILY PRACTICE, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CARRBORO FAMILY MEDICINE CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184394520
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1021 DARRINGTON DR STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27513-8158
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
984-333-2741
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
610 JONES FERRY RD STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARRBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27510-6113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-929-1747
Provider Business Practice Location Address Fax Number:
919-929-4862
Provider Enumeration Date:
09/16/2021

Additional Information

Authorized Official

Authorized Official Last Name:
LONG
Authorized Official First Name:
ASHLEY
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
PRACTICE IMPLEMENTATION MANAGER
Authorized Official Telephone Number:
984-333-2741

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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