FAYETTEVILLE FAMILY MEDICAL CARE, PA (NPI# 1073518536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073518536 |
| Entity Type | Organization |
| Organization Name | FAYETTEVILLE FAMILY MEDICAL CARE, PA |
| Practice Address |
1307 Avon St Fayetteville NC 28304-4423 |
| Practice Telephone | 9103231718 |
| Practice Fax Number | 9103235701 |
| Mailing Telephone | 9103231718 |
| Mailing Fax Number | 9103235701 |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2015-08-19 |
| Authorized Official Name | MRS. ALICE M KUGLER (ADMINISTRATOR) |
| Authorized Official Telephone | 9103231718 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 01559 | 01 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 3442124 | 01 | |
| NC | 8901559 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265707228 | Fayetteville Family Medical Care, Pa | Pharmacy | 1307 Avon St, Fayetteville, NC 28304-4423 | 2012-03-09 |
| Street Address |
1307 AVON ST |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-4423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619490679 | Erika Rae Mcclain | Pharmacist | 1307 Avon St, Fayetteville, NC 28304-4423 | 2017-07-21 |
| 1548704042 | Cumberland County Hospital System Inc | Family Medicine | 1307 Avon St, Fayetteville, NC 28304-4423 | 2016-12-19 |
| 1336517507 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1307 Avon St, Fayetteville, NC 28304-4423 | 2015-09-04 |
| 1558789735 | Jennifer Overby Hall | Physician Assistant | 1307 Avon St, Fayetteville, NC 28304-4423 | 2014-04-03 |
| 1265707228 | Fayetteville Family Medical Care, Pa | Pharmacy | 1307 Avon St, Fayetteville, NC 28304-4423 | 2012-03-09 |
| 1154643898 | Sarah Allen Fazekas | Nurse Practitioner | 1307 Avon St, Fayetteville, NC 28304-4423 | 2010-02-22 |
| 1184679284 | Joshua A. Trujillo | Family Medicine | 1307 Avon St, Fayetteville, NC 28304-4423 | 2006-05-24 |
| 1447240072 | Sharon S Mitchell | Family Medicine | 1307 Avon St, Fayetteville, NC 28304-4423 | 2005-10-25 |
| 1316937972 | Brian K Fleming | Family Medicine | 1307 Avon St, Fayetteville, NC 28304-4423 | 2005-10-25 |
| 1841280401 | Carolyn M Sampson | Family Medicine | 1307 Avon St, Fayetteville, NC 28304-4423 | 2005-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376169185 | Raheem Lalani | Family Medicine | 230 Fieldstone Way, Fayetteville, GA 30215-8170 | 2020-06-18 |
| 1821619370 | Kelly R. Mccarty | Family Medicine | 5872 W Bannister Dr, Fayetteville, AR 72704-6536 | 2020-05-06 |
| 1720620230 | Vector Health and Wellness, LLC | Family Medicine | 1267 N Steamboat Dr Ste 3, Fayetteville, AR 72704-7148 | 2019-10-16 |
| 1295382182 | Nimota Motunrayo Akintoye | Family Medicine | 140 Briergate Pl, Fayetteville, GA 30214-3931 | 2019-08-24 |
| 1609332725 | Fastmed Health Nc, Pllc | Family Medicine | 150 Francam Dr, Fayetteville, NC 28311-4500 | 2019-02-13 |
| 1013486638 | K E Management Services | Family Medicine | 1420 E Augustine Ln Ste 7, Fayetteville, AR 72703-4995 | 2018-11-14 |
| 1659896751 | Melissa Holt | Family Medicine | 108 Medical Center Blvd Ste G-50, Fayetteville, TN 37334-2741 | 2017-08-09 |
| 1124477484 | Mark William Guelzow | Family Medicine | 4101 Medical Center Dr Ste 1c, Fayetteville, NY 13066-6600 | 2016-06-08 |
| 1962865659 | Tracie Fullove | Family Medicine | 3162 W Martin Luther King Blvd Ste 13-14, Fayetteville, AR 72704-7679 | 2016-03-31 |
| 1053778936 | Linda Nancy Robinson | Family Medicine | 7107 Thorntree Hill Dr, Fayetteville, NY 13066-9790 | 2016-01-22 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on FAYETTEVILLE FAMILY MEDICAL CARE, PA.
| 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.