NORTH FAYETTE FAMILY PRACTICE


Address: 290 Highway 314 Ste B, Fayetteville, GA 30214-7813
Phone: 7707168228

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 170100000X Medical Genetics, Ph.D. Medical Genetics 33753 GA Other Service Providers

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1053683359 North Fayette Family Practice Family Medicine 101 Devant St, Suite 902, Fayetteville, GA 30214-2710 2012-02-01

Office Location

Street Address 290 HIGHWAY 314 STE B
City FAYETTEVILLE
State GA
Zip Code 30214-7813

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 170100000X
Grouping Other Service Providers
Classification Medical Genetics, Ph.D. Medical Genetics

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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

Competitor

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City FAYETTEVILLE
Zip Code 30214

Improve Information

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Dataset Information

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.

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