CREEDMOOR CENTRE MEDICAL ASSOCIATES, PA (NPI# 1194893487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194893487 |
| Entity Type | Organization |
| Organization Name | CREEDMOOR CENTRE MEDICAL ASSOCIATES, PA |
| Practice Address |
8311 Bandford Way Suite 007 Raleigh NC 27615-2756 |
| Practice Telephone | 9193900400 |
| Practice Fax Number | 9193900401 |
| Mailing Telephone | 9193900400 |
| Mailing Fax Number | 9193900401 |
| Enumeration Date | 2006-12-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT CRAIG JUER (PRESIDENT) |
| Authorized Official Telephone | 9193839286 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
29127 | NC | Ambulatory Health Care Facilities |
| Street Address |
8311 BANDFORD WAY SUITE 007 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27615-2756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275504532 | George John Kuchenreuther | Optometrist | 8311 Bandford Way, Suite 105, Raleigh, NC 27615-2756 | 2006-01-26 |
| 1891101994 | Myeyedr Optometry of North Carolina Pllc | Optometrist | 8311 Bandford Way, Suite 105, Raleigh, NC 27615-2763 | 2014-07-09 |
| 1306965199 | Ashley Royal Willoughby | Physician Assistant | 8311 Bandford Way, Suite 101, Raleigh, NC 27615-2756 | 2007-03-29 |
| 1194880104 | All About Aesthetics PC | Clinic/Center | 8311 Bandford Way, Suite 103, Raleigh, NC 27615-2756 | 2006-12-27 |
| 1639258718 | Robert C. Juer | Family Medicine | 8311 Bandford Way, Suite 007, Raleigh, NC 27615-2756 | 2006-11-02 |
| 1962593509 | Deborah Kessler Hudak | Dermatology | 8311 Bandford Way, Suite 103, Raleigh, NC 27615-2756 | 2006-09-27 |
| 1104922210 | Vision Park Optometry, P.a. | Optometrist | 8311 Bandford Way, Suite 105, Raleigh, NC 27615-2756 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588278535 | Emily Grace Johnson | Behavior Technician | 119 Wind Chime Court, Suite 4, Raleigh, NC 27615 | 2020-09-06 |
| 1730706110 | Maja V Martin, Dds, Pa1 | Clinic/Center | 7371 Six Forks Road, Raleigh, NC 27615 | 2020-07-01 |
| 1972146967 | Atlantic Avenue Pharmaceutical, Inc | Pharmacy | 5621 Atlantic Ave, Suite 103, Raleigh, NC 27615 | 2019-10-22 |
| 1023503950 | Siyara Shannay Dobbs | Social Worker | 7013 Woodbend Dr Apt H, Raleigh, NC 27615 | 2018-06-23 |
| 1194210153 | Brittanie Ja'nell Harris | Dentist | 1911 Falls Valley Dr Ste 107, Raleigh, NC 27615 | 2018-06-22 |
| 1710489448 | Sherise Swensen | Social Worker | 8368 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2018-03-08 |
| 1881100345 | Casey Paul Baine | Counselor | 6330 Falls of Neuse Rd Ste 104, Raleigh, NC 27615 | 2017-12-20 |
| 1588177885 | Michael Lacidonia | Acupuncturist | 6400 Falls of Neuse Rd Ste 200, Raleigh, NC 27615 | 2017-11-08 |
| 1457877631 | Matt Henderson | Behavioral Analyst | 8374 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2017-08-18 |
| 1760907646 | Shakeda Muldrow | Social Worker | 7323 Brookbank Lane, Raleigh, NC 27615 | 2017-08-11 |
| Find all providers in zip 27615 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003326802 | Essential Health & Wellness Raleigh | Clinic/Center | 2011 Falls Valley Dr Ste 111, Raleigh, NC 27615-3451 | 2017-10-05 |
| 1932571809 | Horizon Family Medicine | Clinic/Center | 308 S Blount St, Apartment 403, Raleigh, NC 27601-3102 | 2015-10-30 |
| 1093146177 | Med One | Clinic/Center | 2431 Spring Forest Rd Ste 111, Raleigh, NC 27615-7525 | 2013-11-27 |
| 1255771119 | Neighborhealth Center, Inc. | Clinic/Center | 4201 Lake Boone Trl Ste 5, Raleigh, NC 27607-7511 | 2013-06-25 |
| 1821266198 | Octavian M. Belcea, Md Pa | Clinic/Center | 2810 Wakefield Pines Dr Ste 115, Raleigh, NC 27614-7078 | 2008-02-20 |
| 1861678120 | Daniel T Sicking Md Pa | Clinic/Center | 14341 New Falls of Neuse Ste 100, Raleigh, NC 27614-8292 | 2008-01-17 |
| 1649352162 | Smartcare Operations Group, Inc. | Clinic/Center | 6140 Falls of The Neuse Road, Raleigh, NC 27609 | 2006-10-20 |
| 1871121269 | Bethany Shaffer Flinchum | Clinic/Center | 3000 New Bern Ave, Raleigh, NC 27610-1231 | 2020-03-31 |
| 1639617392 | Private Diagnostic Clinic | Clinic/Center | 10211 Alm St, Suite 200, Raleigh, NC 27617-8221 | 2017-02-02 |
| 1477099471 | Private Diagnositc Clinic | Clinic/Center | 10211 Alm St, Suite 200, Raleigh, NC 27617-8221 | 2017-01-13 |
| Find all providers in RALEIGH | ||||
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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.