CAPE FEAR AESTHETICS LLC (NPI# 1811192552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811192552 |
| Entity Type | Organization |
| Organization Name | CAPE FEAR AESTHETICS LLC |
| Practice Address |
2053 Valleygate Dr Ste. 102 Fayetteville NC 28304-3688 |
| Practice Telephone | 9103233757 |
| Practice Fax Number | 9103239247 |
| Mailing Telephone | 9103233757 |
| Mailing Fax Number | 9103239247 |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2008-06-18 |
| Authorized Official Name | EDWARD E DICKERSON (OWNER) |
| Authorized Official Telephone | 9103233757 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
NC | Allopathic & Osteopathic Physicians |
| Street Address |
2053 VALLEYGATE DR STE. 102 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-3688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255323176 | Andrea Karen Dickerson | Obstetrics & Gynecology | 2053 Valleygate Dr, Ste. 201, Fayetteville, NC 28304-3688 | 2005-08-17 |
| 1770777336 | Camile Marsh Andrews | Obstetrics & Gynecology | 2053 Valleygate Dr, Ste 201, Fayetteville, NC 28304-3747 | 2007-08-28 |
| 1902958697 | Elena Terece Reynolds | Physician Assistant | 2053 Valleygate Dr, Suite 101, Fayetteville, NC 28304-3747 | 2007-01-16 |
| 1730120916 | Purvi Manish Mehta | Physician Assistant | 2053 Valleygate Dr, Suite 101, Fayetteville, NC 28304-3688 | 2006-06-09 |
| 1326006438 | A Womans Place In Fayetteville Pllc | Obstetrics & Gynecology | 2053 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3688 | 2006-05-01 |
| 1881656932 | Jenny Blanco-doe | Audiologist | 2053 Valleygate Dr, Suite 101, Fayetteville, NC 28304-3688 | 2006-04-04 |
| 1114989266 | Alison C Delap | Audiologist | 2053 Valleygate Dr, Suite 101, Fayetteville, NC 28304-3688 | 2006-04-04 |
| 1679544829 | Eric Lemoine Mansfield | Otolaryngology | 2053 Valleygate Dr, Suite 101, Fayetteville, NC 28304-3688 | 2006-01-27 |
| 1376514521 | Edward Ernest Dickerson, Iv | Otolaryngology | 2053 Valleygate Dr, Suite 102, Fayetteville, NC 28304-3747 | 2006-01-27 |
| 1053303891 | Lakshmi Vadlamudi Gordon | Obstetrics & Gynecology | 2053 Valleygate Dr, Ste. 201, Fayetteville, NC 28304-3688 | 2005-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 2082S0099X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Plastic Surgery Within the Head and Neck |
| A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. A subspecialty certificate was approved by the ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447293584 | Joel M Stewart Jr. | Plastic Surgery | 874 Lanier Ave W, Suite 100, Fayetteville, GA 30214-7662 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245737568 | Triad Ocular and Facial Plastic Surgery Pllc | Plastic Surgery | 122 E Kinderton Way # B, Bermuda Run, NC 27006-7303 | 2018-04-12 |
| 1144484031 | Robin J Hennessy | Plastic Surgery | 315 Arlington Ave, Suite 2003, Charlotte, NC 28203-4240 | 2008-07-10 |
| 1134260854 | Adam David Stein | Plastic Surgery | 4301 Lake Boone Trl Ste 309, Raleigh, NC 27607-7507 | 2007-02-08 |
| 1851738199 | Cynthia M. Gregg, Md, Pllc | Plastic Surgery | 3550 Nw Cary Pkwy, Suite 100, Cary, NC 27513-7409 | 2013-05-28 |
| City | FAYETTEVILLE |
| Zip Code | 28304 |
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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.