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KOG INTEGRATED HEALTHCARE
NPI 1922853514
Family Medicine in Fayetteville, NC

Active since April 18, 2024CLIA 34D2346921 · Waiver
810 ELM ST, FAYETTEVILLE, NC 28303(984) 229-9005(919) 362-0769 Get Directions Write a Review

NPPES record last updated: February 13, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 13, 2025, Apr 18, 2024 (2 updates tracked since 2024).

About Kog Integrated Healthcare NPPES

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

KOG INTEGRATED HEALTHCARE (NPI 1922853514) is a healthcare organization registered as a family medicine in Fayetteville, North Carolina and active in the NPI registry since April 2024. The organization holds a CLIA Waiver certificate valid through July 8, 2028, maintains a secondary practice location in Apex, and lists David Parker, Md/owner, as its authorized official.

NPPES Registry Identity

NPI1922853514
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameKOG INTEGRATED HEALTHCARE
Location Address810 ELM STFayetteville, NC 28303-4152
Mailing Address810 Elm StFayetteville, NC 28303-4152 · (984) 229-9005 · Fax (919) 362-0769
Phone(984) 229-9005
Fax(919) 362-0769
Organization SubpartNo
Authorized OfficialDavid ParkerMd/owner · (984) 229-9005
Enumeration DateApril 18, 2024
Last NPPES UpdateFebruary 13, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 13, 2025
✔ NPI 1922853514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
810 ELM ST, Fayetteville, NC 28303
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Secondary Practice Location 1

Location 11624 White Oak Church Rd Ste 100Apex, NC 27523-6071 · Phone (984) 229-9005 · Fax (919) 362-0769

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kog Integrated Healthcare is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Kog Integrated Healthcare, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Juanita Perkins, FNP
Nurse Practitioner
NPI 1386609568
810 ELM ST
Fayetteville, NC 28303
(910) 491-1089
✔ PECOSSame address
Pamela Harris, MD
Family Practice
NPI 1568626133
439 WESTWOOD SHOPPING CTR
Fayetteville, NC 28314
(910) 286-1923
✔ PECOS✔ Accepts Medicare1.7 mi
David Parker, MD
Family Practice
NPI 1376547356
1248 FORT BRAGG RD SUITE 200
Fayetteville, NC 28305
(910) 486-6818
✔ PECOS✔ Accepts Medicare1.8 mi
Amy Henkel, NP
Nurse Practitioner
NPI 1457603508
1638 OWEN DR
Fayetteville, NC 28304
(910) 615-7036
✔ PECOS✔ Accepts Medicare3.0 mi
Gary Robinson, M.D.
Family Practice
NPI 1457416778
402 N PINE ST
Lumberton, NC 28358
(910) 739-1666
✔ PECOS✔ Accepts Medicare32 mi
Steve Nwanguma, FNP-BC
Nurse Practitioner
NPI 1679355408
6602 KNIGHTDALE BLVD STE 202
Knightdale, NC 27545
(919) 747-5270
✔ PECOS55 mi

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

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 34D2346921

Kog Integrated Health Care · Fayetteville, NC
Active · expires Jul 8, 2028
CLIA Number34D2346921
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateJuly 9, 2026
Certificate Expiration DateJuly 8, 2028
Laboratory DirectorDavid R. Parker
Laboratory Phone(910) 491-1089
Laboratory LocationKog Integrated Health Care810 Elm Street, Fayetteville, NC 28303
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

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 Kog Integrated Healthcare's NPI number?

The NPI number for Kog Integrated Healthcare is 1922853514. It was assigned to this organization in the NPPES registry on April 18, 2024.

Where is Kog Integrated Healthcare located?

Kog Integrated Healthcare is located at 810 Elm St, Fayetteville, NC 28303. The listed phone number is (984) 229-9005.

What is Kog Integrated Healthcare's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kog Integrated Healthcare enrolled in Medicare?

Yes. Kog Integrated Healthcare is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kog Integrated Healthcare?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Kog Integrated Healthcare. 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. The largest specialties are Family Practice (3) and Nurse Practitioner (3). Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Kog Integrated Healthcare hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2346921) is associated with this NPI, valid through July 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kog Integrated Healthcare accept?

Health plans from Blue Cross and Blue Shield of NC list Kog Integrated Healthcare 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.

When was this NPI record last updated?

The NPPES record for Kog Integrated Healthcare was last updated on February 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.