JEFFREY FAWCETT (NPI# 1639591753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639591753 |
| Entity Type | Individual |
| Full Name | JEFFREY FAWCETT |
| Practice Address |
411 Billingsley Rd Ste 104 Charlotte NC 28211-1066 |
| Practice Telephone | 7043777099 |
| Practice Fax Number | 7043777983 |
| Mailing Telephone | 7043777099 |
| Mailing Fax Number | 7043777983 |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2014-01-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Z00000X | Orthotist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1891869780 | 05 |
| Street Address |
411 BILLINGSLEY RD STE 104 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28211-1066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538126255 | Thomas S. Marlowe | Preventive Medicine | 411 Billingsley Rd Ste 104, Charlotte, NC 28211-1066 | 2006-04-27 |
| 1568730968 | Katherine Hausmann | Orthotist | 411 Billingsley Rd Ste 104, Charlotte, NC 28211-1066 | 2011-12-13 |
| 1669797015 | Justin G Ruechel | Orthotist | 411 Billingsley Rd Ste 104, Charlotte, NC 28211-1066 | 2010-03-29 |
| 1326291881 | Vanessa Zaun | Orthotist | 411 Billingsley Rd Ste 104, Charlotte, NC 28211-1066 | 2008-10-28 |
| 1386817336 | Kerr Scott Wheatley | Prosthetist | 411 Billingsley Rd Ste 104, Charlotte, NC 28211-1066 | 2008-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184277832 | I and J Wheelchair Transportation | Non-emergency Medical Transport (VAN) | 1512 Delane Avenue, Charlotte, NC 28211 | 2019-07-22 |
| 1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
| 1649798273 | Ally Home Care Charlotte LLC | In Home Supportive Care | 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 | 2017-09-04 |
| 1154866770 | Vaibhav Bajaj | Dentist | 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 | 2017-01-05 |
| 1508254939 | Lindsay Marie Smits | Speech-Language Pathologist | 427 N. Wendover Rd., Charlotte, NC 28211 | 2015-01-08 |
| 1457755480 | Kristen Hammer | Physical Therapy Assistant | 4120 Providence Rd Apt D, Charlotte, NC 28211 | 2014-10-20 |
| 1669805610 | Carla Elizabeth Scott | Physical Therapist | 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 | 2013-08-14 |
| 1760726368 | Jill Hensdale Shipp | Social Worker | 307 Hunter Lane, Charlotte, NC 28211 | 2012-11-20 |
| 1346592722 | Danielle Marie Benoit | Occupational Therapist | 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 | 2012-10-09 |
| 1487910832 | John Joseph Marcel Jr. | Orthopaedic Surgery | 449 North Wendover Rd Ste A, Charlotte, NC 28211 | 2012-04-10 |
| Find all providers in zip 28211 | ||||
| Taxonomy Code | 222Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Orthotist |
| A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407350507 | Performance Footcare | Orthotist | 2024 Randolph Rd, Charlotte, NC 28207-1216 | 2018-03-22 |
| 1437660834 | Christos George Lemonis | Orthotist | 10420 Park Rd Ste 100a, Charlotte, NC 28210-8501 | 2017-10-12 |
| 1821528373 | Brett Rosen | Orthotist | 309 S Sharon Amity Rd Ste 104, Charlotte, NC 28211-2886 | 2017-06-18 |
| 1518407402 | Kayla Damore | Orthotist | 1901 Brunswick Ave Ste 240, Charlotte, NC 28207-2807 | 2017-02-27 |
| 1851701544 | Megan Marie Olivo | Orthotist | 1228 E Morehead St, Suite 100, Charlotte, NC 28204-2889 | 2014-05-02 |
| 1558797811 | Tyler Dunham | Orthotist | 309 S. Sharon Amity Road, Suite 104, Charlotte, NC 28211-2886 | 2013-09-18 |
| 1891032587 | Alex Richard Ford | Orthotist | 220 Westinghouse Blvd Ste 405, Charlotte, NC 28273-4260 | 2013-01-15 |
| 1992331730 | Andrew Carl Maurer | Orthotist | 2219 E 7th St, Charlotte, NC 28204-3339 | 2020-03-12 |
| 1366911828 | Colleen Cassidy Kerger | Orthotist | 2219 E 7th St, Charlotte, NC 28204-3339 | 2018-11-14 |
| 1710473251 | Mark Gingrich | Orthotist | 2219 E 7th St, Charlotte, NC 28204-3339 | 2018-07-09 |
| Find all providers in CHARLOTTE | ||||
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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.