TENET CENTRAL CAROLINA PHYSICIANS INC (NPI# 1083696926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083696926 |
| Entity Type | Organization |
| Organization Name | TENET CENTRAL CAROLINA PHYSICIANS INC |
| Other Organization Name | MID CAROLINA CROSSROADS SURGICAL CLINIC |
| Practice Address |
709 Wicker St Ste B Sanford NC 27330-4142 |
| Mailing Address |
Po Box 741608 Atlanta GA 30384-1608 |
| Practice Telephone | 9197741277 |
| Practice Fax Number | 9197741101 |
| Mailing Telephone | 9197741277 |
| Mailing Fax Number | 9197741101 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2016-05-26 |
| Authorized Official Name | MR. MICHAEL KYLE BURTNETT (SVP OF OUTPATIENT SERVICES, TENET) |
| Authorized Official Telephone | 4698932153 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5903334 | 05 | |
| RAILROAD MEDICARE | DF0988 | 01 | |
| NC | BCBS | 017MY | 01 |
| Other Name | Type Code |
|---|---|
| Mid Carolina Crossroads Surgical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992787832 | Tenet Central Carolina Physicians Inc | Internal Medicine | 4546 Hwy 87 S, Sanford, NC 27332 | 2005-11-16 |
| Street Address |
709 WICKER ST STE B |
| City | SANFORD |
| State | NC |
| Zip Code | 27330-4142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841495769 | Brian Whitley | Urology | 709 Wicker St, Suite B, Sanford, NC 27330-4167 | 2007-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043836232 | Felicia Alston | Chore Provider | 160a Chatham St, Sanford, NC 27330 | 2020-06-23 |
| 1730727470 | Kathy M Taylor | Homemaker | 1665 Lower Moncure Rd, Sanford, NC 27330 | 2019-12-12 |
| 1982185377 | Fhpg, LLC | Internal Medicine | 2925 Beechtree Dr, Suite 142, Sanford, NC 27330 | 2018-08-24 |
| 1154849719 | Schuyler Karl Behnke | Family Medicine | 125 Chatham Street, Sanford, NC 27330 | 2017-09-05 |
| 1205375953 | Dlp Central Carolina Medical Group LLC | Surgery | 117 Dennis Dr, Sanford, NC 27330 | 2017-02-14 |
| 1760921613 | Open Water Medical, Pa | Family Medicine | 109 South Vance St, Sanford, NC 27330 | 2017-02-13 |
| 1972050458 | Brent Layne | Physician Assistant | 724 South Horner Blvd, Sanford, NC 27330 | 2016-09-01 |
| 1174977185 | Jennifer Lynn Beard | Physician Assistant | 2412 Wilkins Drive, Sanford, NC 27330 | 2016-04-15 |
| 1003277252 | North Carolina Wellness | Community/Behavioral Health | 321a Court Square, Sanford, NC 27330 | 2016-03-16 |
| 1518343573 | The Family Doc Back To Basics Medical Practice, Pllc | General Practice | 1503 Elm Street, Suite C, Sanford, NC 27330 | 2015-07-31 |
| Find all providers in zip 27330 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205375953 | Dlp Central Carolina Medical Group LLC | Surgery | 117 Dennis Dr, Sanford, NC 27330 | 2017-02-14 |
| 1124218169 | Roger Charles Ernest | Surgery | 508 Carthage St, Sanford, NC 27330-4105 | 2007-07-26 |
| 1578609012 | Terry Milton Schroeder | Surgery | 1725 Wilkins Dr, Sanford, NC 27330-7240 | 2007-01-30 |
| 1558415539 | Jennifer Helen Perkins | Surgery | 944 Carolina Way, Sanford, NC 27332-6613 | 2007-01-23 |
| 1902885908 | Michael A Gordon | Surgery | 117 Dennis Drive, Sanford, NC 27330 | 2006-01-10 |
| 1912426115 | Peter Seth Edelstein | Surgery | 1718 Lexington Green Ln, Sanford, FL 32771-1018 | 2017-09-19 |
| 1316485410 | Dlp Central Carolina Medical Group LLC | Surgery | 1139 Carthage St, Suite 110-b, Sanford, NC 27330-4111 | 2017-02-08 |
| 1932566478 | Dlp Central Carolina Physician Practices LLC | Surgery | 1139 Carthage St, Ste 110-b, Sanford, NC 27330-4111 | 2016-01-27 |
| 1578920112 | Dlp Central Carolina Physician Practices LLC | Surgery | 1816 Doctors Dr, Sanford, NC 27330-5057 | 2016-01-27 |
| 1023409729 | Russel K Shaw, Md | Surgery | 247 San Marcos Ave, Sanford, FL 32771-1432 | 2015-02-17 |
| Find all providers in SANFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.