DR. NICHOLAS JOSEPH D'AVANZO (NPI# 1700984812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700984812 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS JOSEPH D'AVANZO |
| Credential | M.D. |
| Practice Address |
3124 Blue Ridge Rd Suite 102 Raleigh NC 27612-8041 |
| Mailing Address |
8512 Bell Grove Way Raleigh NC 27615-3183 |
| Practice Telephone | 9197820021 |
| Practice Fax Number | 9195710825 |
| Mailing Telephone | 9198443225 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2013-04-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 39784 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MEDCOST | 49871 | 01 |
| NC | CIGNA | 6298565 | 01 |
| NC | WELLPATH | 117079 | 01 |
| NC | BCBS OF NC | 27876 | 01 |
| NC | UNITED HEALTHCARE | 1252687 | 01 |
| NC | AETNA | 5204341 | 01 |
| NC | 8927876 | 05 |
| Street Address |
3124 BLUE RIDGE RD SUITE 102 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27612-8041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740274026 | Robert Marshall Horton | Family Medicine | 3124 Blue Ridge Rd, Raleigh, NC 27612-8041 | 2005-09-01 |
| 1982910717 | Robert M Horton Md Pa | Clinic/Center | 3124 Blue Ridge Rd, Suite #101, Raleigh, NC 27612-8041 | 2010-08-31 |
| 1912050469 | David Mccarty Comer | Physician Assistant | 3124 Blue Ridge Rd, Suite 103, Raleigh, NC 27612-8041 | 2007-01-19 |
| 1942389838 | Blue Ridge Pediatrics LLP | Pediatrics | 3124 Blue Ridge Rd, Suite 102, Raleigh, NC 27612 | 2006-11-03 |
| 1275612160 | Ellen Deflora | Pediatrics | 3124 Blue Ridge Rd, Raleigh, NC 27612 | 2006-11-03 |
| 1467405951 | Anant B Soni | Specialist | 3124 Blue Ridge Rd, Suite 103, Raleigh, NC 27612-8041 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538714068 | George J Henderon | Orthotist | 5313 Duraleigh Road, Ste 151, Raleigh, NC 27612 | 2019-08-01 |
| 1902399223 | Iain Knox Nathaniel Irwin | Marriage & Family Therapist | 7701 Alborz Dr, Raleigh, NC 27612 | 2018-06-12 |
| 1225525884 | Patterns Behavioral Services North Carolina, Inc | Assistant Behavior Analyst | 3738 National Dr, Ste 110, Raleigh, NC 27612 | 2018-04-19 |
| 1053820720 | The Art Counseling L.L.C. | Psychologist | 4610 Twisted Oaks Drive Apt 1807, Raleigh, NC 27612 | 2017-09-26 |
| 1376052431 | Amanda Steed | Speech-Language Pathologist | 5519 Hamstead Crossing, Raleigh, NC 27612 | 2017-09-21 |
| 1295250991 | Neal H. Patel Dds Pllc | Dentist | 7211 Shellburne Dr, Raleigh, NC 27612 | 2017-08-03 |
| 1811426109 | Marquita Randolph-breeden | Behavior Technician | 5816 Creedmoor Road, Suite 104, Raleigh, NC 27612 | 2017-06-08 |
| 1336518554 | Travis Edward Williams | Counselor | 4801 Glenwood Ave., Suite 200, Raleigh, NC 27612 | 2015-09-17 |
| 1831587476 | Harris Teeter LLC | Pharmacy | 2051 W Millbrook Road, Raleigh, NC 27612 | 2015-01-06 |
| 1780072975 | Harris Teeter LLC | Pharmacy | 2051 W. Millbrook Road, Raleigh, NC 27612 | 2014-12-23 |
| Find all providers in zip 27612 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174165187 | Breana Lee Chappuis | Pediatrics | 4605 Lord Mario Ct, Raleigh, NC 27610-8718 | 2019-10-10 |
| 1295217008 | Centricity Care, Pllc | Pediatrics | 2417 Bryarton Woods Dr, Raleigh, NC 27606-4022 | 2018-08-29 |
| 1073914024 | Little Oaks Pediatrics, Pllc | Pediatrics | 13200 Strickland Rd Ste 120, Raleigh, NC 27613-5212 | 2014-09-09 |
| 1700144649 | Brett L Maclean | Pediatrics | 5240 Knollwood Rd, Raleigh, NC 27609-4512 | 2012-04-29 |
| 1134412943 | Michael David Brown | Pediatrics | 3000 Newbern Ave, Dept of Pediatrics, Raleigh, NC 27610 | 2011-05-26 |
| 1801041157 | James Gordon Still | Pediatrics | 4816 Oak Way, Raleigh, NC 27613-6346 | 2008-11-28 |
| 1427231943 | Mdfamily Medical Group | Pediatrics | 1100 N Raleigh Blvd Ste 111, Raleigh, NC 27610-1076 | 2007-12-06 |
| 1144415340 | Elizabeth Ann Briere | Pediatrics | 260 Horizon Dr, Raleigh, NC 27615-4922 | 2007-09-11 |
| 1285831347 | Mia N Armstrong | Pediatrics | 23 Sunnybrook Rd Ste 116, Raleigh, NC 27610-7401 | 2007-06-29 |
| 1558405498 | Ceyhun Ozturk | Pediatrics | 13200 Strickland Rd, Suite 120, Raleigh, NC 27613-5212 | 2007-02-16 |
| Find all providers in RALEIGH | ||||
Please comment or provide details below to improve the information on DR. NICHOLAS JOSEPH D'AVANZO.
| 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.