DR. SUBBARAO VENKATA PEMMARAJU (NPI# 1639130008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639130008 |
Entity Type | Individual |
Full Name | DR. SUBBARAO VENKATA PEMMARAJU |
Credential | M.D. |
Practice Address |
2300 Ramsey St Vamc, Division of Ltc/geriatrics, 11g Fayetteville NC 28301-3856 |
Mailing Address |
2938 Lambrusco Pl Fayetteville NC 28306-9282 |
Practice Telephone | 9104882120 |
Mailing Telephone | 9108683717 |
Enumeration Date | 2006-03-28 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
IL | Allopathic & Osteopathic Physicians |
Street Address |
2300 RAMSEY ST VAMC, DIVISION OF LTC/GERIATRICS, 11G |
City | FAYETTEVILLE |
State | NC |
Zip Code | 28301-3856 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619971587 | Nwaobiara Obi-gwacham | Internal Medicine | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2005-06-09 |
1669072492 | Linda Xiong | Pharmacist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-10-30 |
1861092082 | Teresa Wells | Pharmacist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-10-27 |
1528666781 | Amina Chaudhry | Recreation Therapist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-10-11 |
1356957526 | Ashley R Parker | Recreation Therapist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-09-22 |
1295341014 | Andrea Bell Jones | Recreation Therapist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-09-17 |
1770199614 | Tara Anne Bright | Recreation Therapist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-09-16 |
1578177465 | Shani Marcay Hamilton | Respiratory Therapist, Registered | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-09-08 |
1356969562 | Makenzie Lea Benton | Pharmacist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-07-14 |
1942826490 | Jenna Sedberry | Dentist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-06-21 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134726219 | Jenna Michelle Odneal | Behavior Technician | 16915 Liverpool Pkwy. Suite B., Cornelius, NC 28301 | 2020-10-02 |
1790390094 | Jessica Shellman | Counselor | 408 Person St. Ste 103, Fayetteville, NC 28301 | 2020-09-14 |
1487205951 | Martha K Richardson | Technician | 720 Teachers Dr, Fayetteville, NC 28301 | 2019-09-25 |
1013568161 | Angela Rena Locklear | Counselor | 211 Lamon St, Fayeteville, NC 28301 | 2019-09-20 |
1619535747 | Teresa Wilson | Contractor | 1417 Canyionland Ct, Apt 209, Fayetteville, NC 28301 | 2019-06-04 |
1912461815 | Catherine Stevenson Nwogalanya | Community Health Worker | 1103 Hillsboro St., Fayetteville, NC 28301 | 2019-01-24 |
1811443187 | Michael Carroll | Counselor | 308 Peterson Place, Fayetteville, NC 28301 | 2016-08-28 |
1023499886 | Latifa Fedai | Nurse Practitioner | 380 Person Street, Fayettevill, NC 28301 | 2015-06-17 |
1265868939 | Aci Support Specialists | Community/Behavioral Health | 1725 Venna Drive, Fayetteville, NC 28301 | 2013-09-25 |
1871929547 | Aci Support Specialists | Day Training, Developmentally Disabled Services | 2820 Copenhagen Drive, Fayetteville, NC 28301 | 2013-09-25 |
Find all providers in zip 28301 |
Taxonomy Code | 207QG0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Geriatric Medicine |
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
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://wwwtheabfm.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 |
---|---|---|---|---|
1316259013 | Graceful Aging,pc | Family Medicine | 2732 Bardolino Dr, Fayetteville, NC 28306-4636 | 2010-07-09 |
1932295342 | Larry Wayne Barnes | Family Medicine | 2330 Thornton Taylor Pkwy, Suite A, Fayetteville, TN 37334-3672 | 2006-10-04 |
1669436150 | Margaret H Taylor | Family Medicine | 1794 E. Joyce Blvd #2, Fayetteville, AR 72703 | 2006-04-13 |
1427253533 | Highland Rim Medical Center | Family Medicine | 2330 Thornton Taylor Pkwy, Suite A, Fayetteville, TN 37334-3630 | 2007-06-19 |
1841293149 | Cumberland County Hospital Systems, Inc | Family Medicine | 101 Robeson St, Ste 202, Fayetteville, NC 28301-5520 | 2005-05-31 |
1760485080 | Ram Mohan Bongu | Family Medicine | 101 Robeson St, Ste 202, Fayetteville, NC 28301-5520 | 2005-05-31 |
1346243664 | Joyce E Batson | Family Medicine | 101 Robeson St, Suite 202, Fayetteville, NC 28301-5552 | 2005-05-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649765058 | Frances Elizabeth Sutton | Family Medicine | 180 Southwood Dr, Clinton, NC 28328-5002 | 2018-06-27 |
1023313855 | Triangle Geriatrics & Palliative Medicine, Pllc | Family Medicine | 1010 Rosehill Ave, Durham, NC 27705-4019 | 2011-01-26 |
1306092549 | Coastal Mobile Medical Doctor, Pa | Family Medicine | 203 Stagecoach Dr, Jacksonville, NC 28546-9617 | 2008-08-07 |
1457541484 | North River Primecare PC | Family Medicine | 301 Jones Ave, Beaufort, NC 28516-1514 | 2007-07-26 |
1790812840 | Geridoc LLC | Family Medicine | 4431 Montibello Dr, Charlotte, NC 28226-7420 | 2007-02-27 |
1174658371 | Brunswick Gericare PC | Family Medicine | 602 Thomasboro Road, Calabash, NC 28467-9820 | 2007-02-21 |
1952446080 | Jeffrey Dean Martin | Family Medicine | North Carolina Disability Determination Services, 3301 Terminal Dr, Raleigh, NC 27602-0243 | 2007-02-20 |
1912048273 | Shine Thomas | Family Medicine | 1601 Brennar Ave, Salisbury, NC 28144-2515 | 2007-02-09 |
1982766283 | Balaji Pabbu | Family Medicine | 101 Heart Drive, Mail Stop 654, Greenville, NC 27834 | 2006-12-14 |
1417065236 | Narender D Arcot | Family Medicine | 31 Office Park Dr, Jacksonville, NC 28546-3219 | 2006-08-29 |
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City | FAYETTEVILLE |
Zip Code | 28301 |
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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.