| Mcpc-17, Llc | |
|
293 Olmsted Blvd Suite 1 Pinehurst NC 28374-9181 | |
| (910) 255-0033 | |
| (910) 255-0036 |
| Full Name | Mcpc-17, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 293 Olmsted Blvd, Pinehurst, North Carolina |
| Authorized Official Name and Position | Mickey Foster (CEO) |
| Authorized Official Contact | 9107154473 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcpc-17, Llc 293 Olmsted Blvd Ste 1 Pinehurst NC 28374-9182 Ph: (910) 255-0033 | Mcpc-17, Llc 293 Olmsted Blvd Suite 1 Pinehurst NC 28374-9181 Ph: (910) 255-0033 |
| NPI Number | 1518312073 |
|---|---|
| Provider Enumeration Date | 05/03/2016 |
| Last Update Date | 12/30/2024 |
| Medicare PECOS PAC ID | 5395030159 |
|---|---|
| Medicare Enrollment ID | O20160818002018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518312073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Charlita R Mangrum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982693826 PECOS PAC ID: 8820046394 Enrollment ID: I20050111000774 |
| Provider Name | Kim A Finlay-tozzi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962487793 PECOS PAC ID: 1951341908 Enrollment ID: I20050509000988 |
| Provider Name | Joseph A Tozzi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770568529 PECOS PAC ID: 7719904226 Enrollment ID: I20051024001059 |
| Provider Name | William Lee Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619971694 PECOS PAC ID: 7315038353 Enrollment ID: I20070806000755 |
| Provider Name | Ronald D Walters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699798157 PECOS PAC ID: 4082781174 Enrollment ID: I20080915000464 |
| Provider Name | Peter J Dorton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083655211 PECOS PAC ID: 4688718067 Enrollment ID: I20140207001022 |
| Provider Name | Taressa Aleine Bryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821351818 PECOS PAC ID: 4486801123 Enrollment ID: I20160415000230 |
| Provider Name | Joseph Eisele Gillham |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053624296 PECOS PAC ID: 7214204221 Enrollment ID: I20170523001428 |
| Provider Name | Ann Marie T Richards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942611280 PECOS PAC ID: 6305062332 Enrollment ID: I20171013002214 |
| Provider Name | Lisa Ann Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508850892 PECOS PAC ID: 0648463869 Enrollment ID: I20200709002065 |
| Provider Name | Nicole E Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578084927 PECOS PAC ID: 6800162603 Enrollment ID: I20201008000670 |
| Provider Name | Nancy Smyth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003352907 PECOS PAC ID: 5092098186 Enrollment ID: I20220628003481 |
| Provider Name | Kimberly J Valenti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437861754 PECOS PAC ID: 4981076403 Enrollment ID: I20250604000193 |
Mcpc-8, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 Ivey Ln Ste A, Pinehurst, NC 28374 Phone: 910-215-5200 Fax: 910-215-5215 | |
Mcpc-29, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 155 Memorial Dr, Pinehurst, NC 28374 Phone: 910-715-1000 | |
Max Motion Physical Therapy Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 246 Olmsted Blvd Ste D, Pinehurst, NC 28374 Phone: 910-235-0655 Fax: 910-235-0665 | |
Pinehurst Medical Clinic, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 Page Rd, Pinehurst, NC 28374 Phone: 910-295-5511 Fax: 910-235-3443 | |
Mcpc-14, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 305 Page Rd N Ste 1, Pinehurst, NC 28374 Phone: 910-715-8671 Fax: 910-715-6878 | |
Philipp C Wirth Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 80 Aviemore Ct, Pinehurst, NC 28374 Phone: 315-729-0767 | |
Pinehurst Family Care Center,p.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Aviemore Dr, Pinehurst, NC 28374 Phone: 910-215-5555 Fax: 910-215-6134 |