Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. John Michael Neidecker, DO

Individual provider Family Medicine Physician · NPI 1821289174

Dr. John Michael Neidecker, DO is a Sports Medicine in Raleigh, North Carolina. Graduated from Rutgers School of Dental Medicine in 2007, 19 years ago. Practices with Orthopaedic Specialists of North Carolina, PA, a 50-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
19
Trained at
Rutgers School of Dental Medicine
Licensed in
NJ
In the registry since
2007
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

11200 Governor Manly Way Ste 309
Raleigh, NC 27614-7375
Phone: (919) 562-9410
Fax: (919) 562-2948
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 200 W Parkview Dr Ste B, Henderson, NC 27536-5958 — (919) 562-9410
  • 6602 Knightdale Blvd Ste 310, Knightdale, NC 27545-6526 — (919) 562-9410
  • 103 Professional Park Ste A, Oxford, NC 27565-2581 — (919) 562-9410
  • 2605 Blue Ridge Rd Ste 320, Raleigh, NC 27607-6475 — (919) 562-9410

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 207Q00000X (NJ)

Record details

NPI number1821289174
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedAugust 1, 2007
Last updated in NPPESMarch 17, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtySPORTS MEDICINE
Also practisesFAMILY PRACTICE
Medical schoolRUTGERS SCHOOL OF DENTAL MEDICINE
Graduated 2007 (19 years in practice)
Group practice Orthopaedic Specialists Of North Carolina, P.A. — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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