CHIROPRACTIC HEALTH AND WELLNESS CENTER, P. A. (NPI# 1710150016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710150016 |
| Entity Type | Organization |
| Organization Name | CHIROPRACTIC HEALTH AND WELLNESS CENTER, P. A. |
| Practice Address |
5414 Yadkin Rd Fayetteville NC 28303-3199 |
| Practice Telephone | 9104875010 |
| Practice Fax Number | 9104873919 |
| Mailing Telephone | 9104875010 |
| Mailing Fax Number | 9104873919 |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-05-20 |
| Authorized Official Name | DR. DAVID HENRY FONKE (PRESIDENT) |
| Authorized Official Telephone | 9104875010 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2691 | NC | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 0836U | 01 |
| NC | 890836U | 05 |
| Street Address |
5414 YADKIN RD |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-3199 |
| 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 | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801421409 | Jeremy Ray Johnson | Chiropractor | 4155 N Steele Blvd Ste 10, Fayetteville, AR 72703-5377 | 2020-03-04 |
| 1811537129 | Tyler Lee Awe | Chiropractor | 3155 N College Ave Ste 103, Fayetteville, AR 72703-3500 | 2020-01-14 |
| 1982245387 | Aell Spencer Chiropractic Inc | Chiropractor | 3980 W Wedington Dr Ste 14, Fayetteville, AR 72704-5791 | 2019-10-07 |
| 1063975571 | Arkansas Biomechanics & Rehabilitation, Pllc | Chiropractor | 3801 Johnson Mill Blvd Ste A&b, Fayetteville, AR 72704-5297 | 2019-04-11 |
| 1235603200 | Arkansas Holistic Health Care Chiropractic | Chiropractor | 2618 Mlk Jr Blvd, Fayetteville, AR 72701 | 2019-01-14 |
| 1740790716 | Gabriel J Ariciu | Chiropractor | 1678 E Joyce Blvd Ste 1, Fayetteville, AR 72703-6214 | 2017-10-04 |
| 1659895605 | Parker Watkins | Chiropractor | 3761 N Mall Ave Ste 3, Fayetteville, AR 72703-4972 | 2017-08-01 |
| 1780116053 | Goodheart Chiropractic Clinic, Inc. | Chiropractor | 280 Glynn St S, Fayetteville, GA 30214-2014 | 2017-03-28 |
| 1720525041 | Eric Bell | Chiropractor | 2684 Hollybrooke Dr, Fayetteville, AR 72701-9298 | 2017-01-24 |
| 1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
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| 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.