Provider Demographics
NPI:1477890069
Name:CAPE FEAR ORTHOPAEDIC CLINIC, P.A.
Entity Type:Organization
Organization Name:CAPE FEAR ORTHOPAEDIC CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:910-484-2171
Mailing Address - Street 1:4140 FERNCREEK DR
Mailing Address - Street 2:SUITE 801
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2563
Mailing Address - Country:US
Mailing Address - Phone:910-484-2171
Mailing Address - Fax:910-484-4568
Practice Address - Street 1:6000 RAMSEY ST
Practice Address - Street 2:SUITE 108
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-7190
Practice Address - Country:US
Practice Address - Phone:910-484-3332
Practice Address - Fax:910-483-7301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPE FEAR ORTHOPAEDIC CLINIC, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-16
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7901185Medicaid
NC7901185Medicaid
NC0198Medicare PIN