MRS. CRISTIE WELLS FAIRCLOTH (NPI# 1487800314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487800314 |
Entity Type | Individual |
Full Name | MRS. CRISTIE WELLS FAIRCLOTH |
Other Name | MISS CRISTIE MARIE WELLS |
Credential | PA-C, RD, LDN |
Practice Address |
10130 Perimeter Pkwy Ste 200 Charlotte NC 28216-2447 |
Practice Telephone | 8888497379 |
Practice Fax Number | 8558577333 |
Mailing Telephone | 8888497379 |
Mailing Fax Number | 8558577333 |
Enumeration Date | 2008-08-12 |
Last Update Date | 2017-02-10 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 133V00000X | Dietitian, Registered | 915208 | NC | Dietary & Nutritional Service Providers |
N | 133V00000X | Dietitian, Registered | L002256 | NC | Dietary & Nutritional Service Providers |
Y | 363A00000X | Physician Assistant | 0010-1457 | NC | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | BCBS NC | 17998 | 01 |
NC | 8101417 | 05 |
Street Address |
10130 PERIMETER PKWY STE 200 |
City | CHARLOTTE |
State | NC |
Zip Code | 28216-2447 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629025655 | William Simpson Sampson Iv | Psychologist | 10130 Perimeter Pkwy, Ste 200, Charlotte, NC 28216-2447 | 2006-05-27 |
1467824672 | Dana Aubrey Preston | Physician Assistant | 10130 Perimeter Pkwy, Suite 200, Charlotte, NC 28216-2447 | 2015-10-27 |
1225436264 | Truly Therapeutic Rehab Solutions, Pllc | Clinic/Center | 10130 Perimeter Pkwy, Suite 200, Charlotte, NC 28216-2447 | 2014-12-08 |
1174923163 | Carly Davison | Social Worker | 10130 Perimeter Pkwy, Ste 200, Charlotte, NC 28216-2447 | 2014-08-27 |
1083022321 | Valer Consulting | Counselor | 10130 Perimeter Pkwy, Suite 200, Charlotte, NC 28216-2447 | 2014-07-30 |
1326454752 | Lorrie Miller | Counselor | 10130 Perimeter Pkwy, Suite 200, Charlotte, NC 28216-2447 | 2014-07-07 |
1346655891 | Lisette Jenee-moore Deese | Social Worker | 10130 Perimeter Pkwy, Ste 200, Charlotte, NC 28216-2447 | 2014-06-24 |
1598186843 | Scotillia N Mcphaul | Occupational Therapist | 10130 Perimeter Pkwy, Suite 200, Charlotte, NC 28216-2447 | 2014-01-03 |
1912338328 | Onsite Care Pllc | Psychologist | 10130 Perimeter Pkwy, Suite 200, Charlotte, NC 28216-2447 | 2013-12-11 |
1730454729 | Alexis Veronica Lake | Social Worker | 10130 Perimeter Pkwy, Ste 200, Charlotte, NC 28216-2447 | 2012-03-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942837331 | Transit Consortium of South Carolina, LLC | Non-emergency Medical Transport (VAN) | 5025 Roundstone Way, Suite 103, Charlotte, NC 28216 | 2020-03-25 |
1811538796 | Strengthening Families Within Communities LLC | Community/Behavioral Health | 4135 Bryan Furr Drive, Charlotte, NC 28216 | 2019-10-02 |
1841705159 | Karen Sue Rhea | Registered Nurse | 4004 Nicole Eileen Lane, Charlotte, ND 28216 | 2017-12-08 |
1992225890 | Be Free Counseling, Pllc | Social Worker | 7800 Bridle Court, Charlotte, NC 28216 | 2017-06-21 |
1013466416 | Roha Solutions, Inc | Community Based Residential Treatment Facility, Mental Illness | 1529 Jennings St, Charlotte, NC 28216 | 2016-09-26 |
1336595826 | North Carolina Neurodiagnostics, LLC | Clinic/Center | 10130 Perimeter Pwky, Ste. 200, Office 250, Charlotte, NC 28216 | 2016-05-13 |
1346600699 | Elizabeth Ayodele Agiri | Registered Nurse | 9404 Perimeter Station Dr, Apt. 108, Charlotte, NC 28216 | 2016-02-29 |
1922479179 | Prashant Patel | Pharmacist | 9820 Callibridge Court, Charlotte, NC 28216 | 2015-10-14 |
1205226685 | Sarah Baker | Social Worker | 10506 Grobie Way Apt 104, Charlotte, NC 28216 | 2015-01-23 |
1578967089 | The Moon Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4548 Hyperion Court, Charlotte, NC 28216 | 2014-10-13 |
Find all providers in zip 28216 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396351607 | Michael James Blackwell | Physician Assistant | 501 Billingsley Rd Ste B, Charlotte, NC 28211-1009 | 2020-09-22 |
1598371320 | Jonathan Byron Lively | Physician Assistant | 1000 Blythe Blvd Fl 3, Charlotte, NC 28203-5812 | 2020-09-17 |
1902415532 | Jacqueline Ellen Leyrer | Physician Assistant | 2630 E 7th St Ste 200, Charlotte, NC 28204-4319 | 2020-07-29 |
1750908380 | Whitney Debroy | Physician Assistant | 125 W Tremont Ave Unit 726, Charlotte, NC 28203-5551 | 2020-06-30 |
1972129302 | Ashley Nicole Short | Physician Assistant | 1022 E Worthington Ave, Charlotte, NC 28203-5760 | 2020-06-22 |
1558985176 | Courtney Claugus | Physician Assistant | 300 E Park Ave Unit 7, Charlotte, NC 28203-4774 | 2020-05-29 |
1467071738 | Patrick James Quinn | Physician Assistant | 2036 Millerton Ave Apt 4311, Charlotte, NC 28208-5290 | 2020-04-15 |
1225660301 | Sunil Ranchhod Ghodasara | Physician Assistant | 1001 Blythe Blvd Ste 403, Charlotte, NC 28203-5863 | 2020-02-06 |
1225668601 | Emily Rebecca Markey | Physician Assistant | 355 W Mlk Blvd Apt 1112, Charlotte, NC 28202-0043 | 2020-01-24 |
1639719586 | Abosede Elizabeth Adamson | Physician Assistant | 3101 Amesbury Hill Dr, Charlotte, NC 28269-8951 | 2020-01-08 |
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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.