DR. SUSANNAH OGUNWO (NPI# 1376561571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376561571 |
| Entity Type | Individual |
| Full Name | DR. SUSANNAH OGUNWO |
| Credential | MD |
| Practice Address |
7300 S Raeford Rd Fayetteville NC 28304-6162 |
| Practice Telephone | 9104882120 |
| Mailing Telephone | 9104882120 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-05-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 2006-01059 | NC | Allopathic & Osteopathic Physicians |
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
2006-01059 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5904205 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 Robeson St, Suite 202, Fayetteville, NC 283015552 | 9106091630 | 9106091636 |
| Street Address |
7300 S RAEFORD RD |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-6162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013912369 | Albert Vazquez Lugo | Urology | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2005-06-14 |
| 1730795642 | Kathleen Herring Holmes | Social Worker | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2020-09-17 |
| 1033742515 | Cynthia Thompkins | Nurse Practitioner | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2020-02-12 |
| 1588202667 | Jacquelyn Marie Parker | Dietitian, Registered | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2019-12-19 |
| 1861043465 | Karen Parnell | Respiratory Therapist, Registered | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2019-09-25 |
| 1073169959 | Rhomela Imperial Lindo | Nurse Practitioner | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2019-08-15 |
| 1245884428 | Terry Mead Binkley | Respiratory Therapist, Registered | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2019-07-26 |
| 1215581491 | Kelley Andrea Willis | Respiratory Therapist, Registered | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2019-07-26 |
| 1730733908 | Kim Marie Russell | Respiratory Therapist, Registered | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2019-07-26 |
| 1568015964 | Arlene Rice | Respiratory Therapist, Registered | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2019-07-24 |
| Find all providers in the same location | ||||
| 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 | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| 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://wwwtheabfm.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 |
|---|---|---|---|---|
| 1316259013 | Graceful Aging,pc | Family Medicine | 2732 Bardolino Dr, Fayetteville, NC 28306-4636 | 2010-07-09 |
| 1932295342 | Larry Wayne Barnes | Family Medicine | 2330 Thornton Taylor Pkwy, Suite A, Fayetteville, TN 37334-3672 | 2006-10-04 |
| 1669436150 | Margaret H Taylor | Family Medicine | 1794 E. Joyce Blvd #2, Fayetteville, AR 72703 | 2006-04-13 |
| 1427253533 | Highland Rim Medical Center | Family Medicine | 2330 Thornton Taylor Pkwy, Suite A, Fayetteville, TN 37334-3630 | 2007-06-19 |
| 1639130008 | Subbarao Venkata Pemmaraju | Family Medicine | 2300 Ramsey St, Vamc, Division of Ltc/geriatrics, 11g, Fayetteville, NC 28301-3856 | 2006-03-28 |
| 1841293149 | Cumberland County Hospital Systems, Inc | Family Medicine | 101 Robeson St, Ste 202, Fayetteville, NC 28301-5520 | 2005-05-31 |
| 1760485080 | Ram Mohan Bongu | Family Medicine | 101 Robeson St, Ste 202, Fayetteville, NC 28301-5520 | 2005-05-31 |
| 1346243664 | Joyce E Batson | Family Medicine | 101 Robeson St, Suite 202, Fayetteville, NC 28301-5552 | 2005-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649765058 | Frances Elizabeth Sutton | Family Medicine | 180 Southwood Dr, Clinton, NC 28328-5002 | 2018-06-27 |
| 1023313855 | Triangle Geriatrics & Palliative Medicine, Pllc | Family Medicine | 1010 Rosehill Ave, Durham, NC 27705-4019 | 2011-01-26 |
| 1306092549 | Coastal Mobile Medical Doctor, Pa | Family Medicine | 203 Stagecoach Dr, Jacksonville, NC 28546-9617 | 2008-08-07 |
| 1457541484 | North River Primecare PC | Family Medicine | 301 Jones Ave, Beaufort, NC 28516-1514 | 2007-07-26 |
| 1790812840 | Geridoc LLC | Family Medicine | 4431 Montibello Dr, Charlotte, NC 28226-7420 | 2007-02-27 |
| 1174658371 | Brunswick Gericare PC | Family Medicine | 602 Thomasboro Road, Calabash, NC 28467-9820 | 2007-02-21 |
| 1952446080 | Jeffrey Dean Martin | Family Medicine | North Carolina Disability Determination Services, 3301 Terminal Dr, Raleigh, NC 27602-0243 | 2007-02-20 |
| 1912048273 | Shine Thomas | Family Medicine | 1601 Brennar Ave, Salisbury, NC 28144-2515 | 2007-02-09 |
| 1982766283 | Balaji Pabbu | Family Medicine | 101 Heart Drive, Mail Stop 654, Greenville, NC 27834 | 2006-12-14 |
| 1417065236 | Narender D Arcot | Family Medicine | 31 Office Park Dr, Jacksonville, NC 28546-3219 | 2006-08-29 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
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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.