UNIVERSITY OF NORTH CAROLINA AT PEMBROKE STUDENT HEALTH SERVICES (NPI# 1356845309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356845309 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF NORTH CAROLINA AT PEMBROKE STUDENT HEALTH SERVICES |
| Practice Address |
113 Hawk Drive Pembroke NC 28372-1510 |
| Mailing Address |
P.o. Box 1510 One University Drive Pembroke NC 28372-1510 |
| Practice Telephone | 9105216219 |
| Practice Fax Number | 9105216549 |
| Mailing Telephone | 9105216219 |
| Mailing Fax Number | 9105216549 |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2018-03-22 |
| Authorized Official Name | LISA L. SCHAEFFER (VICE CHANCELLOR FOR STUDENT AFFAIRS) |
| Authorized Official Telephone | 9105216175 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
183091 | NC | Allopathic & Osteopathic Physicians |
| Y | 207QA0000X |
Family Medicine Specialization: Adolescent Medicine |
183091 | NC | Allopathic & Osteopathic Physicians |
| Street Address |
113 HAWK DRIVE |
| City | PEMBROKE |
| State | NC |
| Zip Code | 28372-1510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962977 | Kayla J Oxendine | Counselor | 86 Threehunts Drive, Pembroke, NC 28372 | 2020-11-03 |
| 1720688401 | Melissa Claire Kratz | Pharmacist | 930 Hwy 711 East, Pembroke, NC 28372 | 2020-10-30 |
| 1841775681 | Nikki Locklear | Counselor | 86 Three Hunts Dr., Pembroke, NC 28372 | 2018-09-27 |
| 1043703218 | Julie Anne Harrison-swartz | Nurse Practitioner | Uncp Student Health, 113 Hawk Drive, Pembroke, NC 28372 | 2018-06-12 |
| 1134627508 | William Dixon | Specialist/Technologist | One University Drive, Pembroke, NC 28372 | 2018-01-31 |
| 1740796291 | A Primary Choice, Inc. | In Home Supportive Care | 208 Union Chapel Road, Suite D, Pembroke, NC 28372 | 2017-12-20 |
| 1578924130 | William Joshua Johnson | Nurse Practitioner | 3334 Moss Neck Road, Pembroke, NC 28372 | 2016-03-10 |
| 1831560234 | Sungjun Jung | Pharmacist | 930 Nc Hwy 711 E, Pembroke, NC 28372 | 2015-10-12 |
| 1154715027 | Lilly Marie Shorter | Counselor | 86 Three Hunt Drive, Pembroke, NC 28372 | 2015-03-27 |
| 1487046728 | Eye Heart You Home Health, LLC | Public Health or Welfare | 925 University Road, Pembroke, NC 28372 | 2015-02-24 |
| Find all providers in zip 28372 | ||||
| Taxonomy Code | 207QA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adolescent Medicine |
| A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447379110 | Bf&p of Sampson PC | Family Medicine | 105 S. Lisbon Ave, Garland, NC 28441 | 2007-03-27 |
| 1750460549 | Sidney Thomas Greenstone | Family Medicine | 2996 Nc 69 Ste 6, Hayesville, NC 28904-7258 | 2006-11-03 |
| 1558446948 | Lauren Patricia Johnson | Family Medicine | Ncsu Shs, 2815 Cates Ave, Raleigh, NC 27695-7304 | 2006-10-26 |
| 1467469320 | Kent Seitz | Family Medicine | 1421 Orchard Lake Drive, Suite C, Charlotte, NC 28270 | 2006-08-02 |
| 1881675577 | Paul E Trani | Family Medicine | Blue Ridge Community Health Services, Inc, 2579 Chimney Rock Road, Hendersonville, NC 28792 | 2005-11-09 |
| 1588668982 | Pierce Overman | Family Medicine | 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547-2538 | 2005-06-13 |
| 1447254438 | Elizabeth A Deaton | Family Medicine | 615 Shipyard Blvd, Wilmington, NC 28412-6431 | 2005-06-08 |
| 1861822793 | Primary Medical Care | Family Medicine | 270 Cornerstone Dr, Suite 105, Cary, NC 27519-8400 | 2013-11-13 |
| 1144664889 | Kelli Renee Kelderhouse | Family Medicine | 4005 Oleander Dr, Wilmington, NC 28403-6816 | 2013-04-24 |
| 1427304104 | Coleen E Moore | Family Medicine | 4600 Oleander Dr, Wilmington, NC 28403-5149 | 2012-07-31 |
| Find all providers with the same taxonomy | ||||
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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.