FAYETTEVILLE STATE UNIVERSITY (NPI# 1700439023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700439023 |
| Entity Type | Organization |
| Organization Name | FAYETTEVILLE STATE UNIVERSITY |
| Practice Address |
1200 Murchison Road, Fayetteville State University The Fayetteville NC 28301-4252 |
| Practice Telephone | 9106722602 |
| Practice Fax Number | 9106721366 |
| Mailing Telephone | 9106722602 |
| Mailing Fax Number | 9106721366 |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |
| Authorized Official Name | MRS. VINETTE EILY GORDON (DIRECTOR STUDENT HEALTH SERVICES) |
| Authorized Official Telephone | 9106722602 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528547718 | Fayetteville State University | Pharmacy | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2018-08-09 |
| 1063990281 | Fayetteville State University | Clinic/Center | 1200 Murchison Rd, Fayetteville, NC 28301-4252 | 2018-07-31 |
| Street Address |
1200 MURCHISON ROAD, FAYETTEVILLE STATE UNIVERSITY THE |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28301-4252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726219 | Jenna Michelle Odneal | Behavior Technician | 16915 Liverpool Pkwy. Suite B., Cornelius, NC 28301 | 2020-10-02 |
| 1790390094 | Jessica Shellman | Counselor | 408 Person St. Ste 103, Fayetteville, NC 28301 | 2020-09-14 |
| 1487205951 | Martha K Richardson | Technician | 720 Teachers Dr, Fayetteville, NC 28301 | 2019-09-25 |
| 1013568161 | Angela Rena Locklear | Counselor | 211 Lamon St, Fayeteville, NC 28301 | 2019-09-20 |
| 1619535747 | Teresa Wilson | Contractor | 1417 Canyionland Ct, Apt 209, Fayetteville, NC 28301 | 2019-06-04 |
| 1912461815 | Catherine Stevenson Nwogalanya | Community Health Worker | 1103 Hillsboro St., Fayetteville, NC 28301 | 2019-01-24 |
| 1811443187 | Michael Carroll | Counselor | 308 Peterson Place, Fayetteville, NC 28301 | 2016-08-28 |
| 1023499886 | Latifa Fedai | Nurse Practitioner | 380 Person Street, Fayettevill, NC 28301 | 2015-06-17 |
| 1265868939 | Aci Support Specialists | Community/Behavioral Health | 1725 Venna Drive, Fayetteville, NC 28301 | 2013-09-25 |
| 1871929547 | Aci Support Specialists | Day Training, Developmentally Disabled Services | 2820 Copenhagen Drive, Fayetteville, NC 28301 | 2013-09-25 |
| Find all providers in zip 28301 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295943223 | Mohammad A Sabur Nasiri | Clinic/Center | 508 Sandhurst Dr, Fayetteville, NC 28304-4434 | 2007-05-21 |
| 1619908787 | University of Arkansas | Clinic/Center | 525 N Garland Ave, Fayetteville, AR 72701-3110 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450887 | Brocker Health Center/ Unc Charlotte | Clinic/Center | 9201 University City Blvd Student Health Center, Charlotte, NC 28223-0001 | 2020-09-02 |
| 1497132963 | Wingate University | Clinic/Center | 109 N. Camden Rd, Wingate, NC 28174 | 2015-05-04 |
| 1144649948 | Winston-salem State University | Clinic/Center | 1250 S Mlk Jr Dr, Winston Salem, NC 27107-1370 | 2014-04-09 |
| 1538394358 | The University of North Carolina At Asheville | Clinic/Center | One University Heights, Weizenblatt Building, Asheville, NC 28804-8514 | 2009-05-22 |
| 1407038615 | The James A Taylor Student Health Services Sports Medicine Department | Clinic/Center | The James A Taylor Student Health Services Cb# 7470, The University of North Carolina At Chapel Hill, Chapel Hill, NC 27599-7470 | 2007-11-29 |
| 1083807325 | Adolescent Care Center | Clinic/Center | 88 Us Highway 158 W, Gatesville, NC 27938-9438 | 2007-08-21 |
| 1578764312 | Hope Physicians | Clinic/Center | 2502 N Herritage Street, Suite A, Kinston, NC 28501-3567 | 2007-05-30 |
| 1033321005 | Anna Gove Student Health Services | Clinic/Center | 107 Gray Dr., Greensboro, NC 27402 | 2007-05-04 |
| 1073733390 | Davidson College Student Health Service | Clinic/Center | 514 N. Main St, Davidson, NC 28036 | 2007-04-27 |
| 1053452953 | Wake Forest University Student Health Service | Clinic/Center | 1834 Reynolda Road, Mackie Health Center - Reynolds Gym - Wingate Rd. Wfu, Winston-salem, NC 27106 | 2007-02-12 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 28301 |
Please comment or provide details below to improve the information on FAYETTEVILLE STATE UNIVERSITY.
| 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.