ARCHDALE FAMILY PRACTICE PA
NPI 1396049060
Family Medicine in Archdale, NC
About Archdale Family Practice Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ARCHDALE FAMILY PRACTICE PA (NPI 1396049060) is a healthcare organization registered as a family medicine in Archdale, North Carolina and active in the NPI registry since January 2011. The organization lists Mark Craig Beck, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Archdale Family Practice Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Archdale Family Practice PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Archdale Family Practice PA's NPI number?
The NPI number for Archdale Family Practice PA is 1396049060. It was assigned to this organization in the NPPES registry on January 10, 2011.
Where is Archdale Family Practice PA located?
Archdale Family Practice PA is located at 11635 N Main St Ste E, Archdale, NC 27263. The listed phone number is (336) 861-4110.
What is Archdale Family Practice PA's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Archdale Family Practice PA enrolled in Medicare?
Yes. Archdale Family Practice PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Archdale Family Practice PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Archdale Family Practice PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Archdale Family Practice PA was last updated on March 11, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Archdale Family Practice Pa · NPI 1396049060
Family Medicine organization in Archdale, North Carolina. Organization record, active in the CMS NPPES registry since January 10, 2011.
## Identity
- **NPI:** 1396049060 (Entity type: Organization)
- **Enumerated:** January 10, 2011
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Mark Beck, OWNER
## Practice location
- **Address:** 11635 N MAIN ST STE E, Archdale, NC 27263-3271
- **Phone:** (336) 861-4110 · **Fax:** (336) 861-4295
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 11, 2011
- **Other identifiers:** Medicare UPIN C82046; Medicaid 8914271 (NC)
---
Source: [NPI Profile](https://npiprofile.com/npi/1396049060) · Data from the CMS NPPES public registry.