FAYETTEVILLE ORTHOPAEDIC CLINIC, PA


Address: 1991 Fordham Dr, Suite 100, Fayetteville, NC 28304-3650
Phone: 9104843114

FAYETTEVILLE ORTHOPAEDIC CLINIC, PA (NPI# 1417919390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417919390
Entity Type Organization
Organization Name FAYETTEVILLE ORTHOPAEDIC CLINIC, PA
Other Organization Name FAYETTEVILLE ORTHOPAEDICS AND SPORTS MEDICINE
Practice Address 1991 Fordham Dr
Suite 100
Fayetteville
NC 28304-3650
Mailing Address 1991 Fordham Drive
Ste 100
Fayetteville
NC 28304
Practice Telephone 9104843114
Practice Fax Number 9104848824
Mailing Telephone 9104843114
Mailing Fax Number 9104848824
Enumeration Date 2006-04-05
Last Update Date 2012-05-04
Authorized Official Name JAMES ERWIN JOHNSON (PRACTICE ADMINISTRATOR)
Authorized Official Telephone 9102232007
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207X00000X Orthopaedic Surgery NC Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NC 8901555 05

Other Provider/Organization Names

Other Name Type Code
Fayetteville Orthopaedics and Sports Medicine Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1215184924 Fayetteville Orthopaedic Clinic, Pa Orthopaedic Surgery 300 E. Mckay Street, Suite E, Elizabethtown, NC 28337-9037 2008-08-25

Office Location

Street Address 1991 FORDHAM DR
SUITE 100
City FAYETTEVILLE
State NC
Zip Code 28304-3650

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396720173 Kimberly A Barrie Orthopaedic Surgery 1991 Fordham Dr, Suite 100, Fayetteville, NC 28304-3773 2005-12-14
1710594676 Lindsay Taylor Edge Physical Therapist 1991 Fordham Dr, Fayetteville, NC 28304-3773 2020-09-25
1679182851 Deneeka Danielle Whitaker Nurse Practitioner 1991 Fordham Dr, Fayetteville, NC 28304-3773 2020-07-23
1376190751 Tayeshawn Larraine Sembly Nurse Practitioner 1991 Fordham Dr, Fayetteville, NC 28304-3773 2019-08-21
1326596792 Benjamin Sutphin Physical Therapist 1991 Fordham Dr, Suite 102, Fayetteville, NC 28304-3773 2016-09-14
1841748399 Ellen Heath Physical Therapist 1991 Fordham Dr, Suite 102, Fayetteville, NC 28304-3773 2016-09-13
1992151450 Matthew Chase Occupational Therapist 1991 Fordham Dr, Suite 102, Fayetteville, NC 28304-3773 2016-05-13
1063889400 Sean Noonan Physical Therapist 1991 Fordham Dr, Suite 102, Fayetteville, NC 28304-3773 2015-09-01
1770967580 Margaret Mabie Nurse Practitioner 1991 Fordham Dr, Fayetteville, NC 28304-3773 2015-07-13
1730579970 Melissa Owen Specialist/Technologist 1991 Fordham Dr, Suite 100, Fayetteville, NC 28304-3773 2015-01-26
Find all providers in the same location

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207X00000X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery

Taxonomy Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881123578 Resurgens, PC Orthopaedic Surgery 1336 Highway 54 W Ste B, Fayetteville, GA 30214-4573 2017-06-07
1164700068 Nwa Orthopaedic Consulting, Pa Orthopaedic Surgery 161 W Van Asche Dr Ste 101, Fayetteville, AR 72703-4999 2011-07-26
1982809240 Jason C Eck Orthopaedic Surgery 4140 Ferncreek Dr Ste 801, Fayetteville, NC 28314-2572 2007-06-18
1588876791 Powell Orthopedics, Pa Orthopaedic Surgery 3714 N Business Dr Ste 101, Fayetteville, AR 72703-5289 2007-05-03
1316166648 Wesley Kent Cox Orthopaedic Surgery 201 W. Van Asche Loop, Fayetteville, AR 72703-4999 2007-04-25
1073670360 Daniel B. Judd Orthopaedic Surgery 0 Normandy Dr, Department of Orthopaedics, Fayetteville, NC 28307-3465 2007-01-03
1265465157 Navin R Kilambi Orthopaedic Surgery 201 W Van Asche Loop, Fayetteville, AR 72703-4996 2006-07-07
1861441198 Robert J Tomlinson Jr. Orthopaedic Surgery 103 N College Ave Ste 4, Fayetteville, AR 72701-5361 2006-05-05
1750346060 Brett B Greenky Orthopaedic Surgery 4115 Medical Center Dr, Fayetteville, NY 13066-6636 2006-04-19
1982676292 Maurice Lamont Goins Orthopaedic Surgery 1336 West Highway 54, Bldg 500, Fayetteville, GA 30214 2006-02-02
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City FAYETTEVILLE
Zip Code 28304

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Dataset Information

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.

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