SMITH & KOLB FAMILY PRACTICE, PLLC
NPI 1114688223
Nurse Practitioner - Family in Fayetteville, NC

Active since January 02, 2022
413 OWEN DR STE 101, FAYETTEVILLE, NC 28304(910) 740-4361(910) 488-4856 Get Directions Write a Review

NPPES record last updated: January 2, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Smith & Kolb Family Practice, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SMITH & KOLB FAMILY PRACTICE, PLLC (NPI 1114688223) is a healthcare organization registered as a family in Fayetteville, North Carolina and active in the NPI registry since January 2022. The organization lists Buffy Jacobs, Executive Office Manager, as its authorized official.

NPPES Registry Identity

NPI1114688223
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameSMITH & KOLB FAMILY PRACTICE, PLLC
Location Address413 OWEN DR STE 101Fayetteville, NC 28304-3490
Mailing Address413 Owen Dr Ste 101Fayetteville, NC 28304-3490 · (910) 740-4361 · Fax (910) 488-4856
Fax(910) 488-4856
Organization SubpartNo
Authorized OfficialBuffy JacobsExecutive Office Manager · (910) 740-4361
Enumeration DateJanuary 2, 2022
NPPES CertifiedJanuary 1, 2022
NPI 1114688223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
413 OWEN DR STE 101, Fayetteville, NC 28304

Other Identifiers 1

Other1437827490NC · National Provider Identifier

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2258829

Fayetteville Internal Medicine · Fayetteville, NC
Expired · Apr 26, 2026
CLIA Number34D2258829
Laboratory TypePhysician Office
Certificate Effective DateApril 27, 2024
Certificate Expiration DateApril 26, 2026
Laboratory DirectorDebbie C. Smith
Laboratory Phone(910) 483-4680
Laboratory LocationFayetteville Internal Medicine1766 Metro Medical Dr, Fayetteville, NC 28304
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Obstetrics & Gynecology
413 OWEN DR STE 101
FAYETTEVILLE, NC 28304
Nurse Practitioner (Family)
413 OWEN DR STE 101
FAYETTEVILLE, NC 28304
Obstetrics & Gynecology (Gynecologic Oncology)
413 OWEN DR STE 101
FAYETTEVILLE, NC 28304
Obstetrics & Gynecology
413 OWEN DR STE 101
FAYETTEVILLE, NC 28304

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114688223, enumerated as an "organization" on January 02, 2022.

The provider is located at 413 OWEN DR STE 101 FAYETTEVILLE, NC 28304 and the phone number is (910) 740-4361.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.