FAYETTEVILLE ADVANCED PRACTITIONERS (NPI# 1629494265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629494265 |
| Entity Type | Organization |
| Organization Name | FAYETTEVILLE ADVANCED PRACTITIONERS |
| Practice Address |
2915 Raeford Rd Fayetteville NC 28303-5508 |
| Mailing Address |
2915 Raeford Rd Fayetteville NC 28303 |
| Practice Telephone | 9106702047 |
| Mailing Telephone | 9106702047 |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2014-03-26 |
| Authorized Official Name | JAMIE ANN DICKERHOFF (NURSE PRACTITIONER, OWNER) |
| Authorized Official Telephone | 9106702047 |
| Authorized Official Credential | FNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
164680 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
148570 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | NPI | 245538461 | 01 |
| NC | NPI | 1386970572 | 01 |
| Street Address |
2915 RAEFORD RD |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-5508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386623361 | Dawn Fowler Barnes | Nurse Practitioner | 2915 Raeford Rd, Ste 203, Fayetteville, NC 28303-5508 | 2006-01-10 |
| 1326221847 | Mdfamily Medical Group | Pediatrics | 2915 Raeford Rd, Fayetteville, NC 28303-5508 | 2007-12-06 |
| 1508943002 | Angela R. Edwards | Psychologist | 2915 Raeford Rd, 204, Fayetteville, NC 28303-5508 | 2006-11-01 |
| 1255416343 | Dionne Hall | Counselor | 2915 Raeford Rd, Suite 204, Fayetteville, NC 28303-5508 | 2006-10-26 |
| 1659453298 | Sonia M. Rhodie | Psychologist | 2915 Raeford Rd, Suite 204, Fayetteville, NC 28303-5508 | 2006-10-20 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528674181 | Maggie Mullican | Nurse Practitioner | 7084 S Pleasant Ridge Dr, Fayetteville, AR 72704-5447 | 2020-09-18 |
| 1720690167 | Stephen Arthur Lepak | Nurse Practitioner | 6871 Appleton Dr, Fayetteville, PA 17222-9383 | 2020-08-18 |
| 1750990255 | Towauna Daya | Nurse Practitioner | 1338 Redwine Rd, Fayetteville, GA 30215-2509 | 2020-07-30 |
| 1316555642 | Constance Ofundem Takang | Nurse Practitioner | 110 Emerald Lake Ct, Fayetteville, GA 30215-7747 | 2020-07-22 |
| 1851916472 | Breanna Mills | Nurse Practitioner | 2623 N Fire Fly Catch Dr, Fayetteville, AR 72704-6313 | 2020-06-09 |
| 1922621069 | Laura Sarai Perez | Nurse Practitioner | 480 Lees Lake Rd, Fayetteville, GA 30214-3106 | 2020-05-23 |
| 1902431125 | Crystal Baker English | Nurse Practitioner | 113 Old Bethel Rd, Fayetteville, TN 37334-6186 | 2020-03-09 |
| 1568092708 | Stephanie Elizabeth Fields | Nurse Practitioner | 1265 Highway 54 Ste 402, Fayetteville, GA 30214-4537 | 2020-01-15 |
| 1437616364 | Andrea Teal Bergman | Nurse Practitioner | Physicians Medical Walk In Care, 2893 Huntsville Hwy, Fayetteville, TN 37334-6729 | 2019-02-27 |
| 1639634447 | Arica Adams-gro'ce | Nurse Practitioner | 4028 Lifestyle Rd, Fayetteville, NC 28312-9335 | 2019-02-06 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
Please comment or provide details below to improve the information on FAYETTEVILLE ADVANCED PRACTITIONERS.
| 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.