MR. MICHAEL KEITH FARRIS (NPI# 1063754430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063754430 |
Entity Type | Individual |
Full Name | MR. MICHAEL KEITH FARRIS |
Credential | MD |
Practice Address |
557 Brookdale Dr Statesville NC 28677-4107 |
Mailing Address |
Wake Forest University Health Scien 1 Medical Center Blvd. Winston Salem NC 27157-0001 |
Practice Telephone | 3367162255 |
Mailing Telephone | 3367162255 |
Enumeration Date | 2013-03-22 |
Last Update Date | 2018-10-17 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
2018-01589 | NC | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801457460 | Michael Keith Farris | Nurse Practitioner | 4200 Santa Olivia St, Mission, TX 78572-8636 | 2019-06-25 |
1881937050 | Michael Saul Farris | Psychiatry & Neurology | Ohsu-3181 Sw Sam Jackson Park Road, Portland, OR 97239 | 2013-04-05 |
1043324791 | Michael M. Farris | Physician Assistant | 1301 West 38th Street Suite 102, Austin, TX 78705-4107 | 2006-08-19 |
1548238520 | Michael V Farris | Physical Therapist | 121 Enclave Drive, Suite A, New Castle, PA 16105 | 2006-03-08 |
1801891387 | Michael John Farris | Emergency Medicine | 113 W Hickory St, Neosho, MO 64850 | 2005-06-20 |
1619971397 | Michael Douglas Farris | Optometrist | 113 Country Club Dr Ne, Concord, NC 28025-2935 | 2005-06-09 |
1447698428 | Michael Farris | Pharmacist | 4265 Tamiami Trl, Port Charlotte, FL 33980-2152 | 2013-06-12 |
1215262092 | Michael Andrew Farris | Psychologist | 55 Morris Ave, Suite 108, Springfield, NJ 07081-1426 | 2009-10-12 |
Street Address |
557 BROOKDALE DR |
City | STATESVILLE |
State | NC |
Zip Code | 28677-4107 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982606281 | Rocco Joseph Tritico | Specialist | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2005-06-01 |
1396216735 | Wake Forest Emergency Providers | Clinic/Center | 557 Brookdale Dr, Statesville, NC 28677-4100 | 2018-12-11 |
1255807517 | Sarah E Pagano | Nurse Anesthetist, Certified Registered | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2018-10-15 |
1023503265 | Cecilia Kaechele | Nurse Practitioner | 557 Brookdale Dr, Statesville, NC 28677 | 2018-06-29 |
1063900512 | Amanda L Downs | Dietitian, Registered | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2018-04-30 |
1275049207 | Holly Townsend | Specialist/Technologist | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2017-12-28 |
1982115846 | Kayla Pierce | Registered Nurse | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2017-10-18 |
1245757665 | Wake Forest University Health Sciences | Clinic/Center | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2017-08-25 |
1609259183 | Nunta Campbell | Nurse Practitioner | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2015-07-02 |
1811381593 | Iredell Physician Network LLC | General Practice | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2015-03-20 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306472311 | Crystal Medley Hopkins | Nurse Practitioner | 105 Summer Breeze Court, Statesville, NC 28677 | 2020-03-21 |
1922634484 | Tracey Holton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Easterseals Ucp, 913 Carolina Ave N, Statesville, NC 28677 | 2020-03-17 |
1962069286 | Leap Child & Family Services LLC | Developmental Therapist | 119 North Tradd Street, Statesville, NC 28677 | 2019-05-22 |
1831604891 | Ingles Markets Inc | Pharmacy | 722 Sullivan Rd, Statesville, NC 28677 | 2017-12-12 |
1235663162 | Sandra Lorraine Scalese | Physical Therapy Assistant | 520 Valley Street, Brian Center Health and Rehabilitation, Statesville, NC 28677 | 2017-04-18 |
1437698891 | Sherry Blevins Hager | Pharmacist | 722 Sullivan Road, Statesville, NC 28677 | 2017-02-17 |
1063828507 | Susan Marie S Sheffield | Dentist | 518 Brookdale Drive, Statesville, NC 28677 | 2014-07-04 |
1659782449 | Easter Seals Ucp | Community/Behavioral Health | 913 Carolina Ave, Statesville, NC 28677 | 2014-05-14 |
1306268016 | Randall Scott Perry | Dentist | 1132 Davie Avenue, Statesville, NC 28677 | 2014-01-15 |
1215215876 | Silhouette Enterprises | Prosthetic/Orthotic Supplier | 909 Carolina Ave, Statesville, NC 28677 | 2011-08-01 |
Find all providers in zip 28677 |
Taxonomy Code | 2085R0001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Radiation Oncology |
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518301464 | Charles Marc Leyrer | Radiology | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2013-04-22 |
1134322522 | Fairgrove Radiation Oncology, Pa | Radiology | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2007-06-06 |
1841377363 | Gayla S Lowery | Radiology | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2006-11-01 |
1245317767 | Debra B Harr | Radiology | 557 Brookdale Dr, Statesville, NC 28677-4107 | 2006-11-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396121745 | Orit Kaidar - Person | Radiology | 101 Manning Drive, Cb #7512, Radiation Oncology, Chapel Hill, NC 27599-7512 | 2015-08-08 |
1134547201 | Zachary J Reitman | Radiology | 2301 Erwin Rd Duke University Hospital, Durham, NC 27710 | 2014-04-04 |
1861810756 | Susan Gr Mcduff | Radiology | Dumc 20 Duke Medical Center, Durham, NC 27710-0001 | 2014-03-28 |
1679830699 | Colette Joan Shen | Radiology | 101 Manning Drive Cb 7512, Chapel Hill, NC 27599-3307 | 2012-04-15 |
1124397328 | Aaron Tyler Wild | Radiology | 200 Queens Rd Ste 400, Charlotte, NC 28204-3264 | 2011-12-19 |
1891964615 | John William Nelson | Radiology | 5524 Hawthorne Park, Raleigh, NC 27613-6006 | 2008-02-26 |
1194905984 | Daniel G. Baseman | Radiology | 70 Neely Rd, Brevard, NC 28712-4267 | 2007-11-08 |
1285844183 | John S Moody | Radiology | 501 N. Elam Avenue, Greensboro, NC 27403 | 2007-05-22 |
1326251075 | North Carolina Oncology Associates | Radiology | 4101 Macon Pond Road, Raleigh, NC 27607-6319 | 2007-05-08 |
1164552865 | Christopher Ryan Kelsey | Radiology | Morris Building, Science Drive, Room 05135, Durham, NC 27710-0001 | 2007-03-06 |
Find all providers with the same taxonomy |
City | STATESVILLE |
Zip Code | 28677 |
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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.