FAYETTEVILLE FOOT AND ANKLE CENTER (NPI# 1821132424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821132424 |
| Entity Type | Organization |
| Organization Name | FAYETTEVILLE FOOT AND ANKLE CENTER |
| Practice Address |
503 Owen Dr Fayetteville NC 28304-3433 |
| Practice Telephone | 9104833338 |
| Practice Fax Number | 9104833386 |
| Mailing Telephone | 9104833338 |
| Mailing Fax Number | 9104833386 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2011-03-22 |
| Authorized Official Name | DR. GEORGE JOHN DEMETRI JR. (DOCTOR) |
| Authorized Official Telephone | 9104833338 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
240 | NC | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BLUE CROSS BLUE SHIELD | 0153T | 01 |
| NC | 890805F | 05 |
| Street Address |
503 OWEN DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-3433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609288984 | Aaron Teufel | Podiatrist | 1794 E Joyce Blvd Ste 2, Fayetteville, AR 72703 | 2014-05-21 |
| 1073852786 | Ankle and Foot Clinic of Georgia, Inc. | Podiatrist | 730 Lanier Ave W, Fayetteville, GA 30214-1509 | 2013-02-01 |
| 1841597499 | American Foot & Leg Specialists, P.C. | Podiatrist | 122 N Park Dr, Fayetteville, GA 30214 | 2011-02-17 |
| 1861496754 | Gregory Alvarez | Podiatrist | 265 N Jeff Davis Dr, Fayetteville, GA 30214-1625 | 2005-06-08 |
| 1619533692 | Arkansas Foot & Ankle Specialists | Podiatrist | 1794 E Joyce Blvd Ste 2, Fayetteville, AR 72703-5257 | 2019-05-15 |
| 1376906735 | Hughey Colton Carter | Podiatrist | 1738 Metromedical Dr, Fayetteville, NC 28304 | 2016-04-03 |
| 1710256003 | Ozark Foot & Ankle Plc | Podiatrist | 2828 E Millennium Pl, Suite 2, Fayetteville, AR 72703-6514 | 2011-12-15 |
| 1508155037 | Easy Walk Foot Clinic LLC | Podiatrist | 101 Beckett Ln, Suite 104, Fayetteville, GA 30214-7155 | 2011-04-05 |
| 1972827988 | Roberto Bermudez | Podiatrist | 1738 Metromedical Dr, Fayetteville, NC 28304-3861 | 2010-03-19 |
| 1437313194 | Denise Crystal Thomas | Podiatrist | 1738 Metromedical Dr, Fayetteville, NC 28304-3861 | 2008-07-11 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on FAYETTEVILLE FOOT AND ANKLE CENTER.
| 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.