BREEZEWOOD FAMILY HEALTHCARE, PA (NPI# 1356404453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356404453 |
| Entity Type | Organization |
| Organization Name | BREEZEWOOD FAMILY HEALTHCARE, PA |
| Practice Address |
200 Forsythe St Fayetteville NC 28303-5426 |
| Mailing Address |
Po Box 87448 Fayetteville NC 28304-7448 |
| Practice Telephone | 9104850700 |
| Practice Fax Number | 9104839572 |
| Mailing Telephone | 9104850700 |
| Mailing Fax Number | 9104839572 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MICHAEL J. JANSEN (ADMINISTRATOR) |
| Authorized Official Telephone | 9104850700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 116914 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBSNC GROUP NUMBER | 017EM | 01 |
| Street Address |
200 FORSYTHE ST |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-5426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748562 | Gerianne C Geszler | Obstetrics & Gynecology | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2005-05-23 |
| 1962954487 | Total Approach Wellness & Aesthetics | Clinic/Center | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2016-11-01 |
| 1821467044 | Prana Health Pllc | Psychiatry & Neurology | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2015-09-17 |
| 1902212541 | Breezewood Healthcare P A | Non-Pharmacy Dispensing Site | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2014-07-03 |
| 1023337276 | Breezewood Healthcare, P.a. | General Practice | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2010-05-27 |
| 1215175559 | The Center for Health and Restoration, Inc. | General Practice | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2009-01-23 |
| 1952481830 | Cynthia C Phillips | Physician Assistant | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2006-10-16 |
| 1821038209 | Rahul Kumar Kakkar | Internal Medicine | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2006-06-07 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376169185 | Raheem Lalani | Family Medicine | 230 Fieldstone Way, Fayetteville, GA 30215-8170 | 2020-06-18 |
| 1821619370 | Kelly R. Mccarty | Family Medicine | 5872 W Bannister Dr, Fayetteville, AR 72704-6536 | 2020-05-06 |
| 1720620230 | Vector Health and Wellness, LLC | Family Medicine | 1267 N Steamboat Dr Ste 3, Fayetteville, AR 72704-7148 | 2019-10-16 |
| 1295382182 | Nimota Motunrayo Akintoye | Family Medicine | 140 Briergate Pl, Fayetteville, GA 30214-3931 | 2019-08-24 |
| 1609332725 | Fastmed Health Nc, Pllc | Family Medicine | 150 Francam Dr, Fayetteville, NC 28311-4500 | 2019-02-13 |
| 1013486638 | K E Management Services | Family Medicine | 1420 E Augustine Ln Ste 7, Fayetteville, AR 72703-4995 | 2018-11-14 |
| 1659896751 | Melissa Holt | Family Medicine | 108 Medical Center Blvd Ste G-50, Fayetteville, TN 37334-2741 | 2017-08-09 |
| 1124477484 | Mark William Guelzow | Family Medicine | 4101 Medical Center Dr Ste 1c, Fayetteville, NY 13066-6600 | 2016-06-08 |
| 1962865659 | Tracie Fullove | Family Medicine | 3162 W Martin Luther King Blvd Ste 13-14, Fayetteville, AR 72704-7679 | 2016-03-31 |
| 1053778936 | Linda Nancy Robinson | Family Medicine | 7107 Thorntree Hill Dr, Fayetteville, NY 13066-9790 | 2016-01-22 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
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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.