NORTH FAYETTE FAMILY PRACTICE (NPI# 1154431732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154431732 |
Entity Type | Organization |
Organization Name | NORTH FAYETTE FAMILY PRACTICE |
Practice Address |
290 Highway 314 Ste B Fayetteville GA 30214-7813 |
Practice Telephone | 7707168228 |
Mailing Telephone | 7707168228 |
Enumeration Date | 2006-08-30 |
Last Update Date | 2020-08-22 |
Authorized Official Name | KELVIN D WHITE (OWNER) |
Authorized Official Telephone | 7707168228 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 170100000X | Medical Genetics, Ph.D. Medical Genetics | 33753 | GA | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053683359 | North Fayette Family Practice | Family Medicine | 101 Devant St, Suite 902, Fayetteville, GA 30214-2710 | 2012-02-01 |
Street Address |
290 HIGHWAY 314 STE B |
City | FAYETTEVILLE |
State | GA |
Zip Code | 30214-7813 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669087441 | Foster Kennard Lester | Physical Therapy Assistant | 290 Highway 314 Ste B, Fayetteville, GA 30214-7813 | 2020-09-09 |
1053921858 | Kwesi Adedeji Watson | Speech-Language Pathologist | 290 Highway 314 Ste B, Fayetteville, GA 30214-7813 | 2020-08-06 |
1164068292 | Rashad Jackson | Occupational Therapist | 290 Highway 314 Ste B, Fayetteville, GA 30214-7813 | 2019-11-25 |
1710549423 | Odell Anderson Jr. | Physical Therapist | 290 Highway 314 Ste B, Fayetteville, GA 30214-7813 | 2019-07-02 |
1861053464 | Shanice Reeves | Physical Therapist | 290 Highway 314 Ste B, Fayetteville, GA 30214-7813 | 2019-06-25 |
1619535325 | Brittney D Mcghee | Occupational Therapist | 290 Highway 314 Ste B, Fayetteville, GA 30214-7813 | 2019-05-29 |
1164992475 | Kayla Peeples | Occupational Therapist | 290 Highway 314 Ste B, Fayetteville, GA 30214-7813 | 2018-11-29 |
1043701162 | Samson Saint-remy | Occupational Therapist | 290 Highway 314 Ste B, Fayetteville, GA 30214-7813 | 2018-05-24 |
1184113086 | Jane Herr | Physical Therapy Assistant | 290 Highway 314 Ste B, Fayetteville, GA 30214-7813 | 2018-05-07 |
1417452137 | Jason Hill | Massage Therapist | 290 Highway 314 Ste B, Fayetteville, GA 30214-7813 | 2018-03-26 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
Find all providers in zip 30214 |
Taxonomy Code | 170100000X |
Grouping | Other Service Providers |
Classification | Medical Genetics, Ph.D. Medical Genetics |
A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. |
Notes: A general certificate was first issued by ABMS in 1982. ACGME Accredited Residency Program Requirements: None. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215044813 | Joe Mcknitt Alexander Jr. | Medical Genetics, Ph.D. Medical Genetics | 2911 Breezewood Ave Ste 201, Fayetteville, NC 28303 | 2006-08-23 |
1275510695 | Rapha Health System Inc | Medical Genetics, Ph.D. Medical Genetics | 1905 Skibo Rd, Suite 100, Fayetteville, NC 28314-1518 | 2005-12-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801493689 | Zunyan Dai | Medical Genetics, Ph.D. Medical Genetics | 550 Lakehill Way, Johns Creek, GA 30022-7453 | 2020-10-05 |
1447594569 | Harley Anti-aging Institute LLC | Medical Genetics, Ph.D. Medical Genetics | 2678 Buford Highway Ne, Atlanta, GA 30324 | 2012-11-15 |
1659369593 | Joe C Liu | Medical Genetics, Ph.D. Medical Genetics | 5150 Buford Hwy, Ste C-200, Doraville, GA 30340-1153 | 2005-10-13 |
1225564677 | One Health Research Clinic, Inc | Medical Genetics, Ph.D. Medical Genetics | 5430 Jimmy Carter Blvd, Suite 200b, Norcross, GA 30093-1517 | 2017-05-04 |
1790987956 | Sandra W. Helman | Medical Genetics, Ph.D. Medical Genetics | 1120 15th St, Ba1641, Augusta, GA 30912-0004 | 2007-06-01 |
1609993260 | Peter W Benoit | Medical Genetics, Ph.D. Medical Genetics | 3280 Howell Mill Rd Nw, Suite 240, Atlanta, GA 30327-4111 | 2007-03-26 |
1952323057 | Reliant Healthcare LLC | Medical Genetics, Ph.D. Medical Genetics | 1406 Broadrick Drive, Dalton, GA 30720 | 2006-07-25 |
1821047721 | Internal Medicine Education & Research Foundation of Columbus, Inc | Medical Genetics, Ph.D. Medical Genetics | 710 Center St, Columbus, GA 31901-1527 | 2006-05-08 |
City | FAYETTEVILLE |
Zip Code | 30214 |
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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.