MR. BRANDON WARD SCHOONOVER (NPI# 1053449751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053449751 |
Entity Type | Individual |
Full Name | MR. BRANDON WARD SCHOONOVER |
Credential | ATC, PA-C |
Practice Address |
3024 New Bern Ave Suite 304 Raleigh NC 27610-1247 |
Practice Telephone | 7703176522 |
Mailing Telephone | 7703176522 |
Enumeration Date | 2007-03-02 |
Last Update Date | 2016-12-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT001360 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
N | 363A00000X | Physician Assistant | 001003003 | NC | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
0010-03003 | NC | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
3024 NEW BERN AVE SUITE 304 |
City | RALEIGH |
State | NC |
Zip Code | 27610-1247 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588664924 | Lynn M Rebello | Pediatrics | 3024 New Bern Ave, Raleigh, NC 27610 | 2005-07-28 |
1275158206 | Alejandro Ramirez Lopez | Physician Assistant | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2020-06-16 |
1588225759 | Wakemed Specialists Group, LLC | Preventive Medicine | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-06-27 |
1821659079 | Sharon Elizabeth Booth | Physician Assistant | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-06-27 |
1790343366 | Wakemed Specialists Group LLC | Pediatrics | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-30 |
1225693419 | Wakemed Specialists Group LLC | Surgery | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
1720643927 | Wakemed Specialists Group, LLC | Otolaryngology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
1649835836 | Wakemed Specialists Group, LLC | Internal Medicine | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
1205491487 | Wakemed Specialists Group LLC | Urology | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
1639734817 | Wakemed Specialists Group, LLC | Nutritionist | 3024 New Bern Ave, Raleigh, NC 27610-1247 | 2019-05-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609499243 | Elizabeth Ranganai Mavindidze | Social Worker | Wakemed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610 | 2020-05-18 |
1851958839 | Alex & Associates, P.C. | Dentist | 1600 Cross Link Road, Unit 103, Raleigh, NC 27610 | 2019-05-24 |
1639646367 | Carol Mary Medins | Dietitian, Registered | Wakemed Raleigh Medical Park, 23 Sunnybrook Road, Suite 200, Raleigh, NC 27610 | 2018-10-31 |
1144714601 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 123 Sunnybrook Rd Ste 150, Raleigh, NC 27610 | 2018-06-19 |
1417446006 | Eagles Eye Lab, Inc | Clinical Medical Laboratory | 4501 New Bern Ave, Ste: 130, Raleigh, NC 27610 | 2018-05-09 |
1316465206 | Jeffery King Neer | Social Worker | 3010 Falstaff Rd., C/o Unc Actt, Raleigh, NC 27610 | 2017-08-31 |
1083139885 | Kelsey Daniel Mccleave | Social Worker | 3630 Enduring Freedom Drive, Raleigh, NC 27610 | 2017-08-14 |
1891219093 | Tarheel Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4840 Quarryman Road, Raleigh, NC 27610 | 2017-07-29 |
1508214826 | Compassionate Care Providers LLC | Respite Care | 5110 Wetlands, Raleigh, NC 27610 | 2016-05-26 |
1730552530 | Matthew Belair | Pharmacist | 1601-51 Cross Link Rd, Raleigh, NC 27610 | 2015-11-03 |
Find all providers in zip 27610 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407170079 | Stephanie Solosko | Physician Assistant | 8238 Primanti Blvd, Raleigh, NC 27612-7413 | 2010-03-25 |
1386817203 | Katherine Noland Sherron | Physician Assistant | 10941 Raven Ridge Rd Ste 103, Raleigh, NC 27614-6487 | 2008-04-11 |
1053430652 | Sharon Ann Mowrey | Physician Assistant | 3333 Clandon Park Dr, Raleigh, NC 27613-8841 | 2007-03-28 |
1306907043 | Roshni Patel Mapp | Physician Assistant | Duke Thoracic Surgery of Raleigh, 3404 Wake Forest Rd, Suite 201, Raleigh, NC 27609 | 2006-12-13 |
1437186152 | Rita Marie Langworth-brewer | Physician Assistant | 3737 Glenwood Ave, Raleigh, NC 27612-5515 | 2006-06-27 |
1033716634 | Sarah Petty Butler | Physician Assistant | 5838 Six Forks Rd Ste 100, Raleigh, NC 27609-3893 | 2020-10-06 |
1043829534 | Samantha Talbot Brown | Physician Assistant | 4509 Creedmoor Rd Ste 201, Raleigh, NC 27612-3813 | 2020-07-30 |
1093361859 | Kirsten Sinclair Renz | Physician Assistant | 3320 Wake Forest Rd Ste 450, Raleigh, NC 27609-7300 | 2019-08-16 |
1265087076 | Lauren Wells Queen | Physician Assistant | 11200 Governor Manly Way Ste 309, Raleigh, NC 27614-7375 | 2019-08-08 |
1730734211 | Shea Tryon Whittaker | Physician Assistant | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2019-08-02 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.