RALEIGH DURHAM MEDICAL GROUP PA (NPI# 1417907544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417907544 |
| Entity Type | Organization |
| Organization Name | RALEIGH DURHAM MEDICAL GROUP PA |
| Other Organization Name | ALLIANCE FAMILY PRACTICE |
| Practice Address |
4505 Fair Meadows Ln Suite 101 Raleigh NC 27607-6465 |
| Mailing Address |
5420 Wade Park Blvd Suite 106 Raleigh NC 27607-4188 |
| Practice Telephone | 9197839600 |
| Practice Fax Number | 9197839675 |
| Mailing Telephone | 9192335952 |
| Mailing Fax Number | 9198547774 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2014-02-05 |
| Authorized Official Name | DAVID K MOYE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9198512174 |
| Is Organization Subpart | Y |
| Parent Organization Name | RALEIGH DURHAM MEDICAL GROUP PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 0234V | 01 |
| NC | 5900354 | 05 |
| Other Name | Type Code |
|---|---|
| Alliance Family Practice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891704789 | Raleigh Durham Medical Group Pa | Family Medicine | 101 East Corbin St, Hillsborough, NC 27278 | 2006-08-07 |
| 1356387245 | Raleigh Durham Medical Group Pa | Obstetrics & Gynecology | 7019 Harps Mill Rd, Raleigh, NC 27615-3248 | 2006-06-21 |
| 1306899125 | Raleigh Durham Medical Group Pa | Family Medicine | 7124 Knightdale Blvd, Knightdale, NC 27545-9265 | 2006-05-19 |
| 1801848049 | Raleigh Durham Medical Group Pa | Family Medicine | 4905 Green Rd, Ste 100, Raleigh, NC 27616-2805 | 2006-05-16 |
| 1003868258 | Raleigh Durham Medical Group Pa | Family Medicine | 600 New Waverly Place, Ste 203, Cary, NC 27518 | 2006-05-16 |
| 1659322436 | Raleigh Durham Medical Group Pa | Family Medicine | 2076 Highway 42 W, Suite 230, Clayton, NC 27520-5303 | 2006-05-15 |
| 1649221342 | Raleigh Durham Medical Group Pa | Internal Medicine | 4003 N Roxboro St, Durham, NC 27704-2119 | 2006-05-15 |
| 1295784874 | Raleigh Durham Medical Group Pa | Obstetrics & Gynecology | 5420 Wade Park Blvd, Suite 106, Raleigh, NC 27607-4189 | 2006-05-09 |
| 1710331640 | Raleigh Durham Medical Group Pa | Non-Pharmacy Dispensing Site | 8020 Creedmoor Rd, Raleigh, NC 27613-4363 | 2016-04-18 |
| 1164865416 | Raleigh Durham Medical Group Pa | Non-Pharmacy Dispensing Site | 2076 Highway 42 West, Suite 230, Clayton, NC 27520 | 2013-04-16 |
| Street Address |
4505 FAIR MEADOWS LN SUITE 101 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-6465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386636702 | Gail Loretta Lieblang | Nurse Practitioner | 4505 Fair Meadows Ln, Blue Ridge Plaza Suite 204 (unc Clinical Research ), Raleigh, NC 27607-6465 | 2005-08-22 |
| 1154953875 | Kristine Jeter | Nurse Practitioner | 4505 Fair Meadows Ln, Raleigh, NC 27607-6465 | 2020-02-11 |
| 1063937415 | Jill C Vanarthos | Physician Assistant | 4505 Fair Meadows Ln, Raleigh, NC 27607-6465 | 2017-08-07 |
| 1689107039 | Wendy Krull | Social Worker | 4505 Fair Meadows Ln, Raleigh, NC 27607-6465 | 2017-04-04 |
| 1891226858 | Best Day Psychiatry and Counseling, PC | Psychiatry & Neurology | 4505 Fair Meadows Ln, Suite 102, Raleigh, NC 27607-6465 | 2017-03-22 |
| 1558742692 | Monique Link | Psychologist | 4505 Fair Meadows Ln, Suite 106, Raleigh, NC 27607 | 2015-06-15 |
| 1205216181 | Psychological Services of Cindy C. Cottle, Pllc | Psychologist | 4505 Fair Meadows Ln, Ste 106, Raleigh, NC 27607-6465 | 2015-06-04 |
| 1790054500 | Deanna L Towns | Counselor | 4505 Fair Meadows Ln, Suite 211, Raleigh, NC 27607-6465 | 2011-12-22 |
| 1003024928 | Henry H Hancock IIi Dds Ms Pa | Dentist | 4505 Fair Meadows Ln, Suite 220, Raleigh, NC 27607-6465 | 2007-05-21 |
| 1801000252 | William George Bixler | Psychologist | 4505 Fair Meadows Ln, Suite 106, Raleigh, NC 27607-6465 | 2007-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| 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 |
|---|---|---|---|---|
| 1053938894 | American Ecare Telehealth Pllc | Family Medicine | 5312 Pomfret Pt, Raleigh, NC 27612-3683 | 2020-06-27 |
| 1093339368 | Nc Telehealth, Pllc | Family Medicine | 1030 N Rogers Ln Ste 121, Raleigh, NC 27610-6083 | 2020-06-02 |
| 1427680917 | Peter Mcilwaine | Family Medicine | 2605 Blue Ridge Rd Ste 300, Raleigh, NC 27607-6475 | 2020-02-12 |
| 1104483387 | Rebecca Jeffries Cloer | Family Medicine | 8331 Bandford Way Ste 101, Raleigh, NC 27615-2765 | 2019-05-23 |
| 1154888154 | Wwc Medical Pllc | Family Medicine | 7800 Falls of Neuse Rd, #99511, Raleigh, NC 27615-9998 | 2019-02-26 |
| 1932683166 | Good Health Urgent & Primary Care Pllc | Family Medicine | 3716 National Dr Ste 208, Raleigh, NC 27612-4863 | 2018-09-24 |
| 1124501085 | Select Medical Services Pllc | Family Medicine | 10931 Raven Ridge Rd Ste 115, Raleigh, NC 27614-6499 | 2018-09-07 |
| 1215419379 | Patrick Orion Finn | Family Medicine | 10010 Falls of The Neuse Rd, Suite 11, Raleigh, NC 27614 | 2018-09-05 |
| 1740768225 | Iam Healthcare, Pllc | Family Medicine | 5509 Cumberland Plain Dr, Raleigh, NC 27616 | 2018-08-06 |
| 1265963938 | David James Mcmullen | Family Medicine | 3320 Executive Dr Ste 214, Raleigh, NC 27609-7489 | 2017-03-24 |
| Find all providers in RALEIGH | ||||
Please comment or provide details below to improve the information on RALEIGH DURHAM MEDICAL GROUP 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.