LAKEWOOD PEDIATRICS AND FAMILY MEDICINE (NPI# 1881911840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881911840 |
| Entity Type | Organization |
| Organization Name | LAKEWOOD PEDIATRICS AND FAMILY MEDICINE |
| Practice Address |
4003 N Roxboro St Durham NC 27704-2119 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 9192206317 |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2012-10-23 |
| Authorized Official Name | KENNY HEINE (SR. DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 200300427 | NC | Suppliers |
| Street Address |
4003 N ROXBORO ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27704-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649221342 | Raleigh Durham Medical Group Pa | Internal Medicine | 4003 N Roxboro St, Durham, NC 27704-2119 | 2006-05-15 |
| 1821573460 | Anna Elizabeth Turner | Nurse Practitioner | 4003 N Roxboro St, Durham, NC 27704-2119 | 2018-09-29 |
| 1700362803 | Danielle N Knaub | Nurse Practitioner | 4003 N Roxboro St, Durham, NC 27704-2119 | 2018-07-12 |
| 1659796217 | Heather Nelson | Nurse Practitioner | 4003 N Roxboro St, Durham, NC 27704-2119 | 2014-02-19 |
| 1750661187 | Megan Renae Moyles | Nurse Practitioner | 4003 N Roxboro St, Durham, NC 27704-2119 | 2011-08-16 |
| 1588960579 | Jasmine Hemmings | Specialist/Technologist | 4003 N Roxboro St, Durham, NC 27704-2119 | 2011-02-08 |
| 1427101278 | Kimberly Renee Boggs | Physician Assistant | 4003 N Roxboro St, Durham, NC 27704-2119 | 2007-01-18 |
| 1710924311 | Althea H Massenburg | Family Medicine | 4003 N Roxboro St, Durham, NC 27704-2119 | 2006-06-01 |
| 1629015227 | James Arthur Partridge | Family Medicine | 4003 N Roxboro St, Durham, NC 27704-2119 | 2006-06-01 |
| 1538106133 | Poorvi J Shah | Family Medicine | 4003 N Roxboro St, Durham, NC 27704-2119 | 2006-06-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1033625702 | Tondra A Little | Social Worker | 2804 Nellowood Street, Durham, NC 27704 | 2017-12-18 |
| 1437502408 | Jhazmere Shamas Preston | Counselor | 2609 N. Duke St. Suite 403, Durham, NC 27704 | 2016-07-14 |
| 1649626656 | Professional Elevations Pllc | Case Manager/Care Coordinator | 304 Crutchfield Drive, Durham, NC 27704 | 2016-05-09 |
| 1083071617 | Alyssa Wilson | Speech-Language Pathologist | 215 William Penn Plz Apt 908, Durham, NC 27704 | 2016-01-27 |
| 1932565124 | Arthur Reynolds Jr and Associates P.l.l.c. | Dentist | 2106 N Duke St, Durham, NC 27704 | 2016-01-05 |
| 1962877720 | Chimere Brooks | Contractor | 4001meriwether Drive Apt P-19, Durham, NC 27704 | 2015-12-04 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1730581901 | Images, 'of Me To You' | Community/Behavioral Health | 2823 Cascadilla Street, Durham, NC 27704 | 2014-09-19 |
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| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255688594 | Darwich Partners Inc. | Non-Pharmacy Dispensing Site | 2001 Peppertree St, Suite A, Durham, NC 27705-2169 | 2012-08-06 |
| 1548374523 | Planned Parenthood Central Nc | Non-Pharmacy Dispensing Site | Charles W Momteith Md, 105 Newsom St, Durham, NC 27704 | 2006-08-18 |
| 1821409251 | Carolina Partners In Mental | Non-Pharmacy Dispensing Site | 3604 Shannon Rd, Suite 200, Durham, NC 27707-6343 | 2014-05-20 |
| 1639501166 | Planned Parenthood of Central North Carolina, Inc. | Non-Pharmacy Dispensing Site | 105 Newsom St, Suite 101, Durham, NC 27704-2197 | 2013-08-07 |
| 1114263019 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 7010 Nc Highway 751, 101, Durham, NC 27707-5500 | 2012-12-20 |
| 1649350943 | Central Optical, Inc. | Non-Pharmacy Dispensing Site | 2609 N Duke St, Suite 622, Durham, NC 27704-3048 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952775108 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 907 Us 401 Bypass, Laurinburg Commons, Laurinburg, NC 28352 | 2015-11-25 |
| 1417321381 | Urgent Cares of America Nc Inc | Non-Pharmacy Dispensing Site | 5214 Market St, Wilmington, NC 28405-4067 | 2015-11-16 |
| 1003280033 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 825 Blowing Rock Blvd, Lenoir, NC 28645-3709 | 2015-11-13 |
| 1659741361 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 1262 East Broad Avenue, Rockingham, NC 28379 | 2015-10-07 |
| 1740650456 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 220 Us Highway 70 West, Garner, NC 27529 | 2015-10-07 |
| 1033589072 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 6010 Glenwood Ave, Raleigh, NC 27612-2602 | 2015-10-02 |
| 1922478205 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 910 N Madison Blvd, Suite B, Roxboro, NC 27573-4573 | 2015-09-30 |
| 1942679519 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 511 Smoky Park Hwy, Candler, NC 28715-8613 | 2015-09-24 |
| 1164891016 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 212 N Spence Ave, Goldsboro, NC 27534-4318 | 2015-09-22 |
| 1811363674 | Unc Physicians Network, LLC | Non-Pharmacy Dispensing Site | 7100-9 Kit Creek Road, Research Triangle Park, NC 27709 | 2015-08-17 |
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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.