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DR. SHADRACK ANSONG MD
NPI 1528709565
Internal Medicine in Fayetteville, NC

Active since April 05, 2022PECOS EnrolledAccepts Medicare Assignment
1638 OWEN DR, FAYETTEVILLE, NC 28304(910) 615-3960 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 13, 2025, May 29, 2025, Apr 5, 2022 (3 updates tracked since 2022).

About Dr. Shadrack Ansong Md NPPES

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

DR. SHADRACK ANSONG MD (NPI 1528709565) is an individual internal medicine provider in Fayetteville, North Carolina, licensed in North Carolina (2024-03249) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS, is affiliated with Cape Fear Valley Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1528709565
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. SHADRACK ANSONGCredential: MD
Location Address1638 OWEN DRFayetteville, NC 28304-3424
Mailing Address1638 Owen DrFayetteville, NC 28304-3424 · (910) 615-3960
Phone(910) 615-3960
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateApril 5, 2022
Last NPPES UpdateJuly 31, 20253 updates tracked since enumeration
NPPES CertifiedJuly 31, 2025
✔ NPI 1528709565 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NC · 2024-03249
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1638 OWEN DR, Fayetteville, NC 28304
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Secondary Practice Locations 2

Location 1501 S Poplar StElizabethtown, NC 28337-9375 · Phone (910) 862-5100
Location 2210 Medical Pavilion DrRaeford, NC 28376-9111 · Phone (910) 904-8000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Shadrack Ansong Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547644148
PECOS Enrollment IDI20250820000288
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Shadrack Ansong reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cumberland County Hospital System Inc
Same address
Nurse Practitioner
1638 OWEN DR
Fayetteville, NC 28304
  • Reassigned Medicare billing, North Carolina enrollment
  • 906 clinicians in this Medicare group
NPI 1063964708 (910) 615-5490
Bladen Healthcare, LLC
28 mi
Rural Health
16 3RD ST
Dublin, NC 28332
  • Reassigned Medicare billing, North Carolina enrollment
  • 170 clinicians in this Medicare group
NPI 1114193695 (910) 862-3528

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cape Fear Valley Medical Center

Acute Care Hospitals · Fayetteville, NC
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340028
Location1638 Owen Drive P O Box 2000Fayetteville, NC 28302 · Cumberland County
Emergency services Birthing friendly

Southeastern Regional Medical Center

Acute Care Hospitals · Lumberton, NC
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340050
Location300 W 27 St PO Box 1408Lumberton, NC 28359 · Robeson County
Emergency services Birthing friendly

Betsy Johnson Regional Hospital

Acute Care Hospitals · Dunn, NC
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340071
Location800 Tilghman DrDunn, NC 28334 · Harnett County
Emergency services

Cape Fear Valley Hoke Hospital

Acute Care Hospitals · Raeford, NC
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340188
Location210 Medical Pavilion DriveRaeford, NC 28376 · Hoke County
Emergency services

Cape Fear Valley-Bladen County Hospital

Critical Access Hospitals · Elizabethtown, NC
OwnershipVoluntary non-profit - Private
CMS Certification Number341315
Location501 South Poplar StreetElizabethtown, NC 28337 · Bladen County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

MR. KEVIN TRAVIS WORTH CRNA
Nurse Anesthetist, Certified Registered
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-4000
HEATHER MCPHAIL COAXUM NP
Nurse Practitioner (Family)
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-5680
CAPE FEAR VALLEY MEDICAL CENTER
Pharmacist
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-7968
WENDY LYNN BROCK NNP
Nurse Practitioner
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-5490
ABHISHEK GOEL MD
Hospitalist
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-3960
LAUREN WOHLRAB
Student in an Organized Health Care Education/Training Program
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 609-5000
DR. OMAIR MOHAMED
Student in an Organized Health Care Education/Training Program
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-3780
JINGCHUAN WANG MD
Pathology (Anatomic Pathology & Clinical Pathology)
1638 OWEN DR
FAYETTEVILLE, NC 28304
Cumberland County (910) 615-4000

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 Shadrack Ansong's NPI number?

The NPI number for Shadrack Ansong is 1528709565. It was assigned to this individual provider in the NPPES registry on April 5, 2022.

Where is Shadrack Ansong located?

Shadrack Ansong practices at 1638 Owen Dr, Fayetteville, NC 28304. The listed phone number is (910) 615-3960.

What is Shadrack Ansong's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Shadrack Ansong enrolled in Medicare?

Yes. Shadrack Ansong is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Shadrack Ansong's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shadrack Ansong reassigns Medicare benefits to 2 organizations: Cumberland County Hospital System Inc (Fayetteville, NC) and Bladen Healthcare, LLC (Dublin, NC). Each 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 Shadrack Ansong's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shadrack Ansong accept?

Health plans from Cigna Healthcare list Shadrack Ansong as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shadrack Ansong affiliated with any hospitals?

According to CMS data, Shadrack Ansong is affiliated with Cape Fear Valley Medical Center, Southeastern Regional Medical Center, Betsy Johnson Regional Hospital, Cape Fear Valley Hoke Hospital and Cape Fear Valley-Bladen County Hospital.

When was this NPI record last updated?

The NPPES record for Shadrack Ansong was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.