MR. DITTANA PHONCHAROENSRI (NPI# 1750585170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750585170 |
| Entity Type | Individual |
| Full Name | MR. DITTANA PHONCHAROENSRI |
| Credential | M.D. |
| Practice Address |
152 E Kinderton Way Ste 101 Bermuda Run NC 27006-7351 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 3368933180 |
| Practice Fax Number | 3368933189 |
| Mailing Telephone | 3368933180 |
| Mailing Fax Number | 3368933189 |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084S0012X |
Psychiatry & Neurology Specialization: Sleep Medicine |
201300784 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1750585170 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 606 N Elm St, High Point, NC 272624332 | 3368898877 | 3368895250 |
| Street Address |
152 E KINDERTON WAY STE 101 |
| City | BERMUDA RUN |
| State | NC |
| Zip Code | 27006-7351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174144406 | Emily Church Spencer | Nurse Practitioner | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 | 2020-04-28 |
| 1124511985 | Novant Medical Group, Inc. | Internal Medicine | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2018-06-07 |
| 1902398985 | Novant Medical Group, Inc | Neurological Surgery | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 | 2018-06-05 |
| 1265924468 | Novant Medical Group, Inc. | Psychiatry & Neurology | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2018-06-04 |
| 1326466574 | Kent Cochran | Anesthesiology | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2014-04-04 |
| 1124290283 | Kelli Nichols Case | Nurse Practitioner | 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006 | 2008-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942811567 | Venessa Brunt | Home Health | 271 Orchard Park Drive, Advance, NC 27006 | 2020-08-17 |
| 1730707928 | Dara Elzena Green | Physical Therapist | 142 Hollybrook Dr, Advance, NC 27006 | 2020-07-14 |
| 1104339084 | Mark Curry Maynard | Registered Nurse | 125 W Robin Dr, Advance, NC 27006 | 2017-11-14 |
| 1457781585 | Christa Cook | Physical Therapist | 316 N Carolina 801, Advance, NC 27006 | 2013-11-27 |
| 1801029582 | Bonnie T. Bergen | Pharmacist | 260 Us Hwy 801 N, Advance, NC 27006 | 2009-08-28 |
| 1073745485 | Digestive Health Specialists, Pa | Internal Medicine | 112 Kinderton Blvd, Advance, NC 27006 | 2009-08-18 |
| 1114101078 | Dr. Todd Carter D.d.s | Dentist | 123 Nc Highway 801 S. #c-100, Advance, NC 27006 | 2007-12-27 |
| 1437373883 | Adam T. Dorsett | Dentist | 127 Royal Troon Ln, Advance, NC 27006 | 2007-04-13 |
| 1861583882 | Todd H Carter | Dentist | 123 Nc Hwy 801 South, C-100, Advance, NC 27006 | 2006-09-27 |
| 1104927987 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 260 Highway 801, Advance, NC 27006 | 2006-09-26 |
| Find all providers in zip 27006 | ||||
| Taxonomy Code | 2084S0012X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Sleep Medicine |
| A Psychiatrist or Neurologist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders. |
| Notes: Source: American Academy of Sleep Medicine, www.aasm.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356668834 | Carolinas Sleep Specialists Pa | Psychiatry & Neurology | 920 Copperfield Blvd Ne, Concord, NC 28025-2433 | 2010-04-23 |
| 1578890521 | Sound Sleep Interpretations LLC | Psychiatry & Neurology | 2103 Bay Ct, High Point, NC 27265-9323 | 2009-11-12 |
| 1154559847 | Dt Neuro Consulting Pllc | Psychiatry & Neurology | 21 Meadow Crossing Ct, Greensboro, NC 27410-9734 | 2009-07-01 |
| 1265622377 | Novant Medical Group, Inc. | Psychiatry & Neurology | 14215 Ballantyne Coporate Place, Suite 230, Charlotte, NC 28277-3874 | 2007-07-26 |
| 1952423717 | Summit Sleep Disorder Center, Pa | Psychiatry & Neurology | 760 Hartness Rd, Statesville, NC 28677-3425 | 2007-04-04 |
| 1972524361 | Jason A Peck | Psychiatry & Neurology | 8037 Corporate Center Drive, Suite 400, Charlotte, NC 28226-4550 | 2006-07-21 |
| 1265068027 | Watauga Medical Center Inc | Psychiatry & Neurology | 336 Deerfield Rd, Boone, NC 28607-5008 | 2020-03-12 |
| 1386284511 | Greater Carolina Sleep Diagnostics Pllc | Psychiatry & Neurology | 4111 Capitol St Ste A, Durham, NC 27704-2153 | 2020-01-15 |
| 1215411723 | Novant Medical Group Inc | Psychiatry & Neurology | 330 Billingsley Rd Ste 202, Charlotte, NC 28211-5020 | 2018-09-20 |
| 1497232318 | Novant Medical Group Inc | Psychiatry & Neurology | 2801 Randolph Rd Ste 101, Charlotte, NC 28211-1051 | 2018-07-24 |
| Find all providers with the same taxonomy | ||||
| City | BERMUDA RUN |
| Zip Code | 27006 |
Please comment or provide details below to improve the information on MR. DITTANA PHONCHAROENSRI.
| 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.