BUFFALO LAKE MEDICAL PLLC (NPI# 1699178897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699178897 |
| Entity Type | Organization |
| Organization Name | BUFFALO LAKE MEDICAL PLLC |
| Other Organization Name | FAMILY MEDICINE AND ACUTE CARE OF SANDHILLS |
| Practice Address |
181 Mittie Haddock Cameron NC 28326 |
| Mailing Address |
1370 Nc 24/87 Ste 174 Cameron NC 28326 |
| Practice Telephone | 9198425566 |
| Practice Fax Number | 9193752342 |
| Mailing Telephone | 9198425566 |
| Mailing Fax Number | 9193752342 |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2018-08-01 |
| Authorized Official Name | RONNITA HOLDEN (OWNER) |
| Authorized Official Telephone | 9199350939 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 197607 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Family Medicine And Acute Care of Sandhills | Doing Business As Name - Organization |
| Street Address |
181 MITTIE HADDOCK |
| City | CAMERON |
| State | NC |
| Zip Code | 28326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447879903 | Christapher Frank | Nurse Practitioner | 2034 Wesvill Court, Suite 320, Raleigh, NC 28326 | 2020-04-14 |
| 1649825308 | Marisol Lopez | Dentist | 468 Nc Highway 24-87, Cameron, NC 28326 | 2019-08-08 |
| 1033676671 | Amanda Sue Vakos | Behavior Technician | 169 Mattie Haddock Dr, Cameron, NC 28326 | 2019-03-01 |
| 1518475607 | Mirinda Cossel | Assistant Behavior Analyst | 1477 Nc 87, Cameron, NC 28326 | 2018-01-11 |
| 1366961021 | Thomas Peper | Optometrist | 18 Biltmore Ln, Cameron, NC 28326 | 2017-09-13 |
| 1801312020 | Judith Lee Keeney | Behavioral Analyst | 185 Mittie Haddock Drive, Cameron, NC 28326 | 2017-08-18 |
| 1013455864 | Rita Mashburn | Pharmacist | 2800 Nc Hwy 24-87, Cameron, NC 28326 | 2017-02-01 |
| 1578951042 | Womack Army Medical Center | Clinic/Center | 55 Centennial Parkway, Cameron, NC 28326 | 2015-01-06 |
| 1629487137 | Raymond J. Tseng Dds, Phd, I, Pa | Dentist | 1520 Nc Highway 24/87, Cameron, NC 28326 | 2014-08-08 |
| 1669891289 | Olsen & Olsen, I, Pa | Clinic/Center | 1524 Nc Highway 87 South, Cameron, NC 28326 | 2014-04-10 |
| Find all providers in zip 28326 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194208355 | Laraine Kiser | Physician Assistant | 181 Mittie Haddock Dr, Cameron, NC 28326-9379 | 2018-09-12 |
| 1912550443 | Alex Witmer | Physician Assistant | 2694 Nc 24-87, Cameron, NC 28326-6957 | 2019-07-23 |
| 1134695026 | North Carolina Center for Weight Management | Physician Assistant | 181 Mittie Haddock Dr, Cameron, NC 28326-9379 | 2018-10-17 |
| 1871687533 | Margaret M J Dancer | Physician Assistant | 1600 E Evergreen St, Suite C, Cameron, MO 64429-2400 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538459 | Sarah Jane Lamanna | Physician Assistant | 3012 Bristol Creek Dr, Morrisville, NC 27560-7811 | 2020-11-04 |
| 1043819741 | Brad Russell Tolan | Physician Assistant | 211 Pinegate Cir Apt 12, Chapel Hill, NC 27514-2221 | 2020-10-22 |
| 1265030654 | Vanessa Vinson | Physician Assistant | 284 Lower Edgewood Rd, Candler, NC 28715-9285 | 2020-10-16 |
| 1649878810 | Courtney Michelle Watlington | Physician Assistant | 360 N Bennett St, Southern Pines, NC 28387-4813 | 2020-10-11 |
| 1669079034 | Christine Meyer | Physician Assistant | 2523 Creek Ridge Ln, Chapel Hill, NC 27514-7454 | 2020-10-07 |
| 1407453319 | Khyan Waddell | Physician Assistant | 127 Sneed Rd, Enfield, NC 27823-9589 | 2020-10-04 |
| 1053918979 | Amjad Ali | Physician Assistant | 730 Montlieu Ave, High Point, NC 27260-4000 | 2020-10-04 |
| 1104433382 | Aditi Bhattacharjee Sundaresan | Physician Assistant | 131 Mallard Ct, Chapel Hill, NC 27517-9104 | 2020-09-30 |
| 1689281933 | Kathryn Tarulli | Physician Assistant | 600 W Main St Apt 624, Durham, NC 27701-5005 | 2020-09-29 |
| 1205443991 | Kelsey Mendez | Physician Assistant | 105 Basket Oak Dr, Bunnlevel, NC 28323-9141 | 2020-09-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BUFFALO LAKE MEDICAL PLLC.
| 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.