LAFAYETTE CLINIC, PA (NPI# 1356455059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356455059 |
| Entity Type | Organization |
| Organization Name | LAFAYETTE CLINIC, PA |
| Practice Address |
2125 Valleygate Dr Suite 201 Fayetteville NC 28304-3753 |
| Mailing Address |
Po Box 43905 Fayetteville NC 28309-3905 |
| Practice Telephone | 9103231322 |
| Practice Fax Number | 9103231510 |
| Mailing Telephone | 9103231322 |
| Mailing Fax Number | 9103231510 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-11-18 |
| Authorized Official Name | DR. DOUGLAS WAYNE WHETSELL (PRESIDENT) |
| Authorized Official Telephone | 9103231322 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0201X |
Pediatrics Specialization: Pediatric Allergy/Immunology |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
Allopathic & Osteopathic Physicians | ||
| Y | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 890138G | 05 | |
| BLUE CROSS BLUE SHIELD | 0138G | 01 | |
| RAILROAD MEDICARE | CN6121 | 01 |
| Street Address |
2125 VALLEYGATE DR SUITE 201 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-3753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467455899 | All American Rehabilitation Solutions | Physical Therapist | 2125 Valleygate Dr, Suite 101, Fayetteville, NC 28304-3753 | 2005-05-31 |
| 1528419744 | American Arthritis & Rheumatology Associates-nc Pllc | Internal Medicine | 2125 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3753 | 2016-06-29 |
| 1538558663 | Katherine Cole | Physician Assistant | 2125 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3753 | 2015-01-13 |
| 1013227495 | Shelley Barry Follett | Nurse Practitioner | 2125 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3753 | 2010-10-19 |
| 1174747711 | Blood and Cancer Clinic, Pa | Non-Pharmacy Dispensing Site | 2125 Valleygate Dr, Suite 101, Fayetteville, NC 28304-3657 | 2007-04-13 |
| 1437275161 | Pamela Hudak | Physician Assistant | 2125 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3753 | 2007-03-22 |
| 1134269251 | Seema S Devasthali | Physical Therapist | 2125 Valleygate Dr, Suite 101-a, Fayetteville, NC 28304-3657 | 2007-02-07 |
| 1649354317 | Casey Cathleen Benander | Physical Therapist | 2125 Valleygate Dr, Suite 101, Fayetteville, NC 28304-3753 | 2006-10-25 |
| 1780697326 | Gwenesta Barnum Melton | Internal Medicine | 2125 Valleygate Dr, Suite 201, Fayetteville, NC 28304-3753 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710218995 | Medical Associates of Northwest Arkansas | Allergy & Immunology | 3383 N Mana Ct, Suite 201, Fayetteville, AR 72703-4960 | 2010-01-27 |
| 1740408731 | Stella M Castro | Allergy & Immunology | 4402 Medical Center Dr, Suite 402, Fayetteville, NY 13066-6626 | 2007-04-23 |
| 1912944828 | Howard J Silk | Allergy & Immunology | 1240 Highway 54 W, Building 300 Suite 310, Fayetteville, GA 30214-4557 | 2006-05-31 |
| 1992795397 | Sarah Kim | Allergy & Immunology | 1317 Medical Dr, Fayetteville, NC 28304-4425 | 2005-10-26 |
| 1659405231 | Colin Freccia | Allergy & Immunology | 1317 Medical Dr, Fayetteville, NC 28304-4418 | 2007-03-15 |
| 1053320515 | Howard G Oaks | Allergy & Immunology | 1317 Medical Dr, Fayetteville, NC 28304-4418 | 2006-08-05 |
| 1790720795 | Kevin R. Keller | Allergy & Immunology | 3344 N Futrall Dr, Fayetteville, AR 72703-4057 | 2006-06-17 |
| 1124077078 | Laura Jane Koehn | Allergy & Immunology | 2100 N Green Acres Rd, Suite A, Fayetteville, AR 72703-2807 | 2006-05-09 |
| 1417906371 | Martha Ann Hutson-fincher | Allergy & Immunology | 2100 N Green Acres Rd, Suite A, Fayetteville, AR 72703-2807 | 2006-05-09 |
| 1407805468 | Allergy Care Center | Allergy & Immunology | 2100 N Green Acres Rd, Suite A, Fayetteville, AR 72703-2807 | 2006-05-08 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on LAFAYETTE CLINIC, PA.
| 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.