KHALED F JREISAT (NPI# 1396843132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396843132 |
| Entity Type | Individual |
| Full Name | KHALED F JREISAT |
| Credential | MD |
| Practice Address |
3806 Peachtree Ave Suite 110 Wilmington NC 28403-6751 |
| Mailing Address |
34 Office Park Dr Ste 100 Jacksonville NC 28546-3221 |
| Practice Telephone | 9103994197 |
| Practice Fax Number | 9103994223 |
| Mailing Telephone | 9103533624 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 11599 | NC | Other Service Providers |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
27377 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 89133VH | 05 |
| Street Address |
3806 PEACHTREE AVE SUITE 110 |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28403-6751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598214587 | Lauren Victoria Hill | Counselor | 3806 Peachtree Ave, Suite 210, Wilmington, NC 28403-6751 | 2016-10-01 |
| 1770891103 | Waccamaw Imaging, LLC | Clinic/Center | 3806 Peachtree Ave, Wilmington, NC 28403-6751 | 2010-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413875 | Ymca of Southeastern Nc | Health Educator | 2710 Market Street, Wilmington, NC 28403 | 2020-09-25 |
| 1659917334 | Noa Alper | Occupational Therapist | 5412 Old Garden Road, Wilmington, NC 28403 | 2019-11-18 |
| 1992346340 | Nancy Rosita Carson | Technician | 5608 Locke Str. Apt 108, Wilmington, NC 28403 | 2019-10-07 |
| 1912484585 | Jennifer Nicole Perry | Behavior Technician | 349 Campus Cv, Wilmington, NC 28403 | 2018-07-25 |
| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1114445731 | Jacqulyn Craichy | Speech-Language Pathologist | 75 Cavalier Drive, Wilmington, NC 28403 | 2017-09-04 |
| 1730638545 | Ashley Mcneil | Durable Medical Equipment & Medical Supplies | 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 | 2016-09-22 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1689039992 | Lifeline Treatment Center | Clinic/Center | 5710 Oleander Dr Ste 100, Wilmington, NC 28403 | 2015-12-31 |
| 1750758264 | Melissa Beatson | Speech-Language Pathologist | 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 | 2015-09-01 |
| Find all providers in zip 28403 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033597224 | Carolina Healthcare Associates Inc | Psychiatry & Neurology | 1509 Doctors Cir, Bldg C, Wilmington, NC 28401-7403 | 2015-05-08 |
| 1467683722 | Rawad Obeid | Psychiatry & Neurology | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2009-08-05 |
| 1366621906 | Sanjai C. Rao D.o., Inc. | Psychiatry & Neurology | 3521 Silverside Rd, Quillen Bldg, Suite 2i-2, Wilmington, DE 19810-4900 | 2007-10-31 |
| 1013106491 | Catherine F. Bodak-gyovai | Psychiatry & Neurology | 1600 Rockland Road, Wilmington, DE 19803-3607 | 2007-10-22 |
| 1346323045 | Anand Gundakaram | Psychiatry & Neurology | 1600 Rockland Rd, Wilmington, DE 19803-3607 | 2006-10-24 |
| 1285726026 | Mena T. Scavina | Psychiatry & Neurology | A.i. Dupont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803-3607 | 2006-09-29 |
| 1790876050 | Charles Brill | Psychiatry & Neurology | A.i. Dupont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803-3607 | 2006-09-28 |
| 1932290228 | Stephen J. Falchek | Psychiatry & Neurology | A.i. Dupont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803-3607 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033675079 | Novant Medical Group Inc | Psychiatry & Neurology | 1918 Randolph Rd Ste 320, Charlotte, NC 28207-1109 | 2019-02-14 |
| 1740547496 | Dmitry Tchapyjnikov | Psychiatry & Neurology | Dept of Pediatrics Duke University Medical Ctr, 2301 Erwin Rd., Children's Health Center, Duke Universi, Durham, NC 27710-0001 | 2012-04-19 |
| 1043525280 | Cmc-northeast, Inc. | Psychiatry & Neurology | 6600 Wilkinson Blvd, Carolinas Pediatric Neurology Care - Holy Angels, Belmont, NC 28012-2796 | 2010-08-12 |
| 1750610689 | Virinder Nohria | Psychiatry & Neurology | 111 Skyline View Rd, Franklin, NC 28734-4769 | 2009-12-24 |
| 1144463993 | Monica Elizabeth Lemmon | Psychiatry & Neurology | Dumc 3936, Durham, NC 27710-6667 | 2009-04-09 |
| 1245431600 | Yael Shiloh-malawsky | Psychiatry & Neurology | 170 Manning Dr., Department of Neurology Cb#7025, Chapel Hill, NC 27514-4220 | 2007-05-31 |
| 1598795635 | Kadry R Allaboun | Psychiatry & Neurology | 115 Foothills Dr, Morganton, NC 28655-5152 | 2006-07-04 |
| 1962473033 | David Jay Jaffe | Psychiatry & Neurology | 508 Sandhurst Dr, A, Fayetteville, NC 28304-4434 | 2006-01-27 |
| 1558368936 | Susan B Boutilier | Psychiatry & Neurology | 2280 Hemby Ln, Greenville, NC 27834-3773 | 2005-06-30 |
| 1164987616 | Novant Medical Group Inc | Psychiatry & Neurology | 311 Coddle Market Dr Nw, Ste 200, Concord, NC 28027-2432 | 2019-02-08 |
| Find all providers with the same taxonomy | ||||
| City | WILMINGTON |
| Zip Code | 28403 |
Please comment or provide details below to improve the information on KHALED F JREISAT.
| 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.