DR. PAYTON GREGORY FENNELL (NPI# 1306906086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306906086 |
| Entity Type | Individual |
| Full Name | DR. PAYTON GREGORY FENNELL |
| Credential | D.O |
| Practice Address |
52 12th Ave Ne Hickory NC 28601 |
| Mailing Address |
52 12th Ave Ne Hickory NC 28601-2798 |
| Practice Telephone | 8284853004 |
| Practice Fax Number | 8283284049 |
| Mailing Telephone | 8284853004 |
| Mailing Fax Number | 8283284049 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2019-01-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 200601317 | NC | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
200601317 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1306906086 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5641 Poplar Tent Rd, Suite 101, Concord, NC 280277533 | 7047821955 | 7047923903 |
| Street Address |
52 12TH AVE NE |
| City | HICKORY |
| State | NC |
| Zip Code | 28601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477517159 | Wesley N. Reid | Physician Assistant | 52 12th Ave Ne, Hickory, NC 28601 | 2006-04-12 |
| 1023532728 | Dlp Frye Medical Group LLC | Neuromusculoskeletal Medicine, Sports Medicine | 52 12th Ave Ne, Hickory, NC 28601-2798 | 2017-08-03 |
| 1235659707 | Dlp Hickory Family Practice Associates LLC | Emergency Medicine | 52 12th Ave Ne, Hickory, NC 28601-2798 | 2017-06-26 |
| 1427597111 | Dlp Frye Medical Group LLC | Family Medicine | 52 12th Ave Ne, Hickory, NC 28601-2798 | 2017-02-15 |
| 1396100871 | Dlp Hickory Family Practice Associates LLC | Nurse Practitioner | 52 12th Ave Ne, Hickory, NC 28601-2798 | 2015-12-28 |
| 1831449057 | Hickory Family Practice Associates-tenet North Carolina, LLC | Family Medicine | 52 12th Ave Ne, Hickory, NC 28601-2798 | 2012-09-14 |
| 1851698195 | Katherine A. Hemby | Family Medicine | 52 12th Ave Ne, Hickory, NC 28601-2798 | 2011-02-23 |
| 1568490001 | John K. Earl | Family Medicine | 52 12th Ave Ne, Hickory, NC 28601-2695 | 2006-06-30 |
| 1720016355 | James R. Hodges | Family Medicine | 52 12th Ave Ne, Hickory, NC 28601-2695 | 2006-06-30 |
| 1598792962 | William L. Young IIi | Family Medicine | 52 12th Ave Ne, Hickory, NC 28601-2695 | 2006-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555236 | Mathew Ryan Dunn | Specialist/Technologist | 755 5th St Ne, Hickory, NC 28601 | 2020-10-14 |
| 1669086757 | Alex Neil Hines | Massage Therapist | 2759 North Center Street, Hickory, NC 28601 | 2020-09-04 |
| 1306327515 | Natasha Anderson | Nurse Practitioner | 2830 16th St Ne Apt 94, Hickory, NC 28601 | 2018-08-25 |
| 1902382120 | Danielle Marie Cisney | Counselor | 1219 10th Street Blvd Nw Apt F, Hickory, NC 28601 | 2018-07-11 |
| 1295243681 | Maggie Isabelle Mccarrick | Specialist/Technologist | 2225 6th St Nw, Hickory, NC 28601 | 2018-01-19 |
| 1487165395 | Healthstat Onsite Clinic Hsm Metal | Preventive Medicine | 180 Mcdonald Parkway Sw, Hickory, NC 28601 | 2017-10-18 |
| 1407249691 | Alexcia Dawn Pennell | Registered Nurse | 1501 Tate Blvd Sw, Suite 201, Hickory, NC 28601 | 2015-03-11 |
| 1134527484 | Pamilla Griffin Yount | Specialist | 825 3rd Ave. Nw, Hickory, NC 28601 | 2014-12-18 |
| 1831593615 | Josephine Lovelace Polhemus | Pharmacist | 12th Avenue Ne, Hickory, NC 28601 | 2014-10-22 |
| 1275957128 | Amy Lor | Acupuncturist | 46 Cloninger Mill Rd Ne Ste E, Hickory, NC 28601 | 2014-02-13 |
| Find all providers in zip 28601 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1760831028 | William M Sykes | Family Medicine | 129 T.t. Lanier St., Buies Creek, NC 27506 | 2016-06-08 |
| 1730561655 | Brendan Jay Michel | Family Medicine | 437 Little Fisher Trl, Mount Airy, NC 27030-6900 | 2015-06-27 |
| 1699179804 | Carolinas Physicians Network Inc | Family Medicine | 48380 Us Highway 52 N, Misenheimer, NC 28109 | 2014-10-17 |
| 1548509805 | Carolinas Physician Network, Inc. | Family Medicine | 332 North Trade Street, Suite 1200, Matthews, NC 28105-6566 | 2013-02-06 |
| 1699903211 | Robert Alcott | Family Medicine | 6050 W Highway 74, Ste D, Indian Trail, NC 28079-3591 | 2009-06-23 |
| 1962637926 | Thomas Joseph Thekkekandam | Family Medicine | 1635 Nc Highway 66 S, Suite 210, Kernersville, NC 27284-3854 | 2009-05-20 |
| 1477738714 | Forsyth Medical Group, LLC. | Family Medicine | 1900 S Hawthorne Rd Ste 480, Dba Sports Medicine Associates, Winston Salem, NC 27103-3913 | 2008-01-07 |
| 1396938171 | Lawrence M Linett, Md, Pllc | Family Medicine | 431 Western Blvd Ste E, Jacksonville, NC 28546-6823 | 2007-08-24 |
| 1962536516 | Richard T. Ferro | Family Medicine | 6832 Market St, Suite A, Wilmington, NC 28405-9723 | 2007-03-15 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. PAYTON GREGORY FENNELL.
| 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.