1497778369 NPI number — JAMES S. MCFADDEN, MD,PA

Table of content: (NPI 1497778369)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497778369 NPI number — JAMES S. MCFADDEN, MD,PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES S. MCFADDEN, MD,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:
Provider Other Organization Name Type Code:
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:
1497778369
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 MCDONALD RD W
Provider Second Line Business Mailing Address:
PO BOX 5398
Provider Business Mailing Address City Name:
PINEHURST
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28374-8946
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-295-2920
Provider Business Mailing Address Fax Number:
910-295-4640

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
35 MCDONALD RD W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PINEHURST
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28374-8946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-295-2920
Provider Business Practice Location Address Fax Number:
910-295-4640
Provider Enumeration Date:
07/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCFADDEN
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
STUART
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
910-295-2920

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  40471 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 201498 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 02452 . This is a "BCBS GROUP NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 56525 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7902452 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: NPB002 . This is a "SC EDS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 201498B . This is a "MEDICARE INDIVIDUAL ID #" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: QC0313 . This is a "SC EDS INDIVIDUAL" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 050007881 . This is a "RR MEDICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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