MADHUR GUPTA (NPI# 1588818298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588818298 |
| Entity Type | Individual |
| Full Name | MADHUR GUPTA |
| Credential | M.D. |
| Practice Address |
11200 Governor Manly Way Suite 205 Raleigh NC 27614-8599 |
| Mailing Address |
11200 Governor Manly Way, Suite 205 Rex Family Practice of Wakefeild Raleigh NC 27614 |
| Practice Telephone | 9195707700 |
| Mailing Telephone | 9195707700 |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2017-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2008-01811 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5910699 | 05 | |
| NC | BCBS | 1508F | 01 |
| Street Address |
11200 GOVERNOR MANLY WAY SUITE 205 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27614-8599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194708263 | Edgar Xavier Correa | Podiatrist | 11200 Governor Manly Way, Suite 309, Raleigh, NC 27614-8599 | 2005-11-22 |
| 1437769080 | Jerrell Parker | Physical Therapy Assistant | 11200 Governor Manly Way, Raleigh, NC 27614-8599 | 2020-08-07 |
| 1255997086 | Kendra Rae Potter | Physician Assistant | 11200 Governor Manly Way, Raleigh, NC 27614-8599 | 2019-05-16 |
| 1942719752 | Lisa Susanna Izzi | Specialist/Technologist | 11200 Governor Manly Way, Raleigh, NC 27614-8599 | 2017-09-25 |
| 1053843664 | Brooke Graves | Physician Assistant | 11200 Governor Manly Way, Raleigh, NC 27614-8599 | 2017-04-02 |
| 1356881528 | John Michael Ablan | Prevention Professional | 11200 Governor Manly Way, Raleigh, NC 27614-8599 | 2017-03-07 |
| 1174074769 | Kelsey Leigh Mancini | Specialist/Technologist | 11200 Governor Manly Way, Suite 309, Raleigh, NC 27614-8599 | 2016-10-18 |
| 1124579008 | Taylor Beavers | Specialist/Technologist | 11200 Governor Manly Way, Raleigh, NC 27614-8599 | 2016-10-17 |
| 1215483540 | Nicole Emilia Renfroe | Student in an Organized Health Care Education/Training Program | 11200 Governor Manly Way, Raleigh, NC 27614-8599 | 2016-08-28 |
| 1649725177 | Chelsea Christine Sorensen | Specialist/Technologist | 11200 Governor Manly Way, Raleigh, NC 27614-8599 | 2016-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215419379 | Patrick Orion Finn | Family Medicine | 10010 Falls of The Neuse Rd, Suite 11, Raleigh, NC 27614 | 2018-09-05 |
| 1538652557 | Amn Medical Group Pllc | General Practice | 13200 Falls of Neuse Rd Ste 113, Raleigh, NC 27614 | 2018-06-13 |
| 1497201727 | Kelsey Scheerer | Student in an Organized Health Care Education/Training Program | 11200 Governor Way, Raleigh, NC 27614 | 2016-08-28 |
| 1538521463 | Liane Rudd | Speech-Language Pathologist | 4700 Norbury Place, Raleigh, NC 27614 | 2016-03-21 |
| 1891088068 | Michelle Lynn Thompson | Pharmacist | 10930 Raven Ridge Road, Raleigh, NC 27614 | 2011-05-22 |
| 1821396185 | Bettye Jo Johnson | Physical Medicine & Rehabilitation | 11200 Governor Manly Way, Suite 305, Orhopaedic Specialists of North Carolina, Pa, Raleigh, NC 27614 | 2011-03-09 |
| 1982900650 | Blake Jennings Lamm | Pharmacist | 14460 New Falls of Neuse Rd, Suite 165, Raleigh, NC 27614 | 2011-01-28 |
| 1013223023 | Lauren S Lawler | Pharmacist | 11201 Durant Road, Raleigh, NC 27614 | 2010-08-27 |
| 1588985378 | Kashif Mazhar | General Acute Care Hospital | 10010 Falls of Neuse Road, Suite #12, Raleigh, NC 27614 | 2010-06-16 |
| 1922240100 | Harris Teeter, LLC | Durable Medical Equipment & Medical Supplies | 14520 John Rex Blvd, Raleigh, NC 27614 | 2009-04-02 |
| Find all providers in zip 27614 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938894 | American Ecare Telehealth Pllc | Family Medicine | 5312 Pomfret Pt, Raleigh, NC 27612-3683 | 2020-06-27 |
| 1093339368 | Nc Telehealth, Pllc | Family Medicine | 1030 N Rogers Ln Ste 121, Raleigh, NC 27610-6083 | 2020-06-02 |
| 1427680917 | Peter Mcilwaine | Family Medicine | 2605 Blue Ridge Rd Ste 300, Raleigh, NC 27607-6475 | 2020-02-12 |
| 1104483387 | Rebecca Jeffries Cloer | Family Medicine | 8331 Bandford Way Ste 101, Raleigh, NC 27615-2765 | 2019-05-23 |
| 1154888154 | Wwc Medical Pllc | Family Medicine | 7800 Falls of Neuse Rd, #99511, Raleigh, NC 27615-9998 | 2019-02-26 |
| 1932683166 | Good Health Urgent & Primary Care Pllc | Family Medicine | 3716 National Dr Ste 208, Raleigh, NC 27612-4863 | 2018-09-24 |
| 1124501085 | Select Medical Services Pllc | Family Medicine | 10931 Raven Ridge Rd Ste 115, Raleigh, NC 27614-6499 | 2018-09-07 |
| 1215419379 | Patrick Orion Finn | Family Medicine | 10010 Falls of The Neuse Rd, Suite 11, Raleigh, NC 27614 | 2018-09-05 |
| 1740768225 | Iam Healthcare, Pllc | Family Medicine | 5509 Cumberland Plain Dr, Raleigh, NC 27616 | 2018-08-06 |
| 1265963938 | David James Mcmullen | Family Medicine | 3320 Executive Dr Ste 214, Raleigh, NC 27609-7489 | 2017-03-24 |
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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.