RAVENHILL DERMATOLOGY MEDICAL CLINIC, P.C. (NPI# 1962519462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962519462 |
| Entity Type | Organization |
| Organization Name | RAVENHILL DERMATOLOGY MEDICAL CLINIC, P.C. |
| Practice Address |
110 Barcelona Dr Fayetteville NC 28303-4453 |
| Practice Telephone | 9104854101 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2008-06-16 |
| Authorized Official Name | DEBBIE REINELT (BILLING) |
| Authorized Official Telephone | 8288915524 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8983124 | 05 | |
| BLUE CROSS BLUE SHIELD | 83124 | 01 |
| Street Address |
110 BARCELONA DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-4453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093161440 | Dennis Polley II | Physician Assistant | 110 Barcelona Dr, Fayetteville, NC 28303-4453 | 2016-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306061031 | Northhills Dermatology | Dermatology | 3256 N Northhills Blvd, Fayetteville, AR 72703 | 2007-04-16 |
| 1679695233 | Coressence Inc | Dermatology | 103 Hay St, Fayetteville, NC 28301-5649 | 2007-04-04 |
| 1629158142 | Manfred S Rothstein | Dermatology | 1308 Medical Dr, Fayetteville, NC 28304 | 2006-10-17 |
| 1447350640 | Alvin Harold Clair | Dermatology | 874 W. Lanier Ave, Suite 270, Fayetteville, GA 30214-7617 | 2006-09-25 |
| 1679682520 | Lance B. Henry | Dermatology | 1444 E Stearns St, Suite 11, Fayetteville, AR 72703-6243 | 2006-08-30 |
| 1306860119 | Douglas Walsh | Dermatology | 4110 Medical Center Drive, Dermatology Associates, Fayetteville, NY 13066-2075 | 2006-07-26 |
| 1285664623 | Carla T Lee | Dermatology | 4120 Thornton Taylor Pkwy Ste F, Fayetteville, TN 37334-2292 | 2006-07-03 |
| 1396784443 | Robert D Brown | Dermatology | 4375 N. Vantage Drive, Suite 305, Fayetteville, AR 72703 | 2006-06-05 |
| 1932154606 | Wendell Weller Weed | Dermatology | 3256 N North Hills Blvd, Fayetteville, AR 72703 | 2006-05-23 |
| 1255321782 | Denise Ladd | Dermatology | 2300 Ramsey Street, Va Medical Center, Fayetteville, NC 28301 | 2005-10-26 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
Please comment or provide details below to improve the information on RAVENHILL DERMATOLOGY MEDICAL CLINIC, P.C..
| 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.