CARDINAL CLINIC, LLC (NPI# 1437373578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437373578 |
| Entity Type | Organization |
| Organization Name | CARDINAL CLINIC, LLC |
| Practice Address |
1540 Purdue Dr Ste 200 Fayetteville NC 28303-5510 |
| Practice Telephone | 9108678889 |
| Practice Fax Number | 9104873061 |
| Mailing Telephone | 9108678889 |
| Mailing Fax Number | 9104873061 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CAROL E. DOYLE (QUALITY MANAGEMENT DIRECTOR) |
| Authorized Official Telephone | 9102226234 |
| Authorized Official Credential | RHIA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5900672 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033427091 | Cardinal Clinic, LLC | Case Management | 1540 Purdue Drive, Suite 200, Fayetteville, NC 28303-5510 | 2010-09-23 |
| Street Address |
1540 PURDUE DR STE 200 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-5510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053339283 | Deitra Letrice Williams-toone | Anesthesiology | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2006-07-17 |
| 1194225490 | Caroline Miller Harris | Physical Medicine & Rehabilitation | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2018-02-14 |
| 1023156932 | Theodore W. Lane | Psychologist | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2007-02-02 |
| 1659419430 | Aaron Melvin | Social Worker | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2007-02-02 |
| 1609925668 | Cardinal Clinic LLC | Counselor | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2007-01-09 |
| 1982761250 | Cardinal Clinic LLC | Counselor | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2007-01-03 |
| 1700967395 | Cardinal Clinic L.L.C. | Counselor | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2006-10-18 |
| 1679653588 | Brenda M. Dixon | Counselor | 1540 Purdue Dr Ste 200, Fayetteville, NC 28303-5510 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609316694 | Suzanne Nicholas LLC | Psychiatry & Neurology | 2224 Riverfront Ln, Fayetteville, AR 72703-9527 | 2017-02-24 |
| 1417310491 | Murray Fork Clinic, PC | Psychiatry & Neurology | 6020 Morganton Road, Fayetteville, NC 28314-1352 | 2016-03-29 |
| 1003225491 | Johari Family Services, LLC | Psychiatry & Neurology | 701 Whitfield St, Fayetteville, NC 28306-1617 | 2014-08-11 |
| 1609154509 | Saguaro Group LLC | Psychiatry & Neurology | 2800 Breezewood Drive, Ste 100, Fayetteville, NC 28303-5282 | 2011-07-26 |
| 1699065110 | Jacquelyn Rae Lange-halley | Psychiatry & Neurology | 2580 E Joyce Blvd Ste 1, Fayetteville, AR 72703-3924 | 2011-04-18 |
| 1124343918 | Dorothee S Mecum | Psychiatry & Neurology | 28 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2010-04-05 |
| 1922269018 | Kevin M Lamm | Psychiatry & Neurology | 1724 Roxie Avenue, Fayetteville, NC 28304 | 2008-06-20 |
| 1780871152 | Atul Kantesaria Md Pllc | Psychiatry & Neurology | 105 Hunter Cir, Fayetteville, NC 28304-3407 | 2007-10-01 |
| 1942496005 | James Robert Parks | Psychiatry & Neurology | 102 E Sunbridge Dr, Suite 1, Fayetteville, AR 72703-2830 | 2007-09-21 |
| 1144353699 | Trevor Nagib Iskander | Psychiatry & Neurology | 280 Salt Springs St, Fayetteville, NY 13066-2258 | 2007-03-13 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
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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.