CAMP CREEK PEDIATRICS (NPI# 1891065504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891065504 |
| Entity Type | Organization |
| Organization Name | CAMP CREEK PEDIATRICS |
| Other Organization Name | CHARLENE JOHNSON, MD |
| Practice Address |
495 Virginia Highlands Fayetteville GA 30215-8233 |
| Mailing Address |
2945 Stone Hogan Connector Rd Sw Ste 201 Atlanta GA 30331-2839 |
| Practice Telephone | 7704606459 |
| Mailing Telephone | 4043496758 |
| Mailing Fax Number | 4043496759 |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |
| Authorized Official Name | KATHY ANN DYSON (BILLING MANAGER) |
| Authorized Official Telephone | 7707451070 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 049655 | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Charlene Johnson, MD | Former Legal Business Name - Organization |
| Street Address |
495 VIRGINIA HIGHLANDS |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30215-8233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801370051 | Truly Nourished, LLC | Dietitian, Registered | 500 West Lanier Ave., Suite 908, Fayetteville, GA 30215 | 2018-09-23 |
| 1104343839 | Pandora G Brown | Specialist | 65 Black Watch Ct, Fayetteville, GA 30215 | 2017-08-23 |
| 1902264492 | Ty-re Lamont Dixon Sr. | Durable Medical Equipment & Medical Supplies | 220 Shoreline Dr., Fayetteville, GA 30215 | 2016-01-29 |
| 1962870030 | Matthew Christian Alvarez | Dentist | 113 Ebenezer Rd Ste 101, Fayetteville, GA 30215 | 2015-09-08 |
| 1831534346 | Kevin Tyler Goelz | Radiology | 605 Wentworth Ct, Fayetteville, GA 30215 | 2013-05-10 |
| 1518249739 | William J. Holcomb | Pharmacist | 880 Hwy 85 South, Fayetteville, GA 30215 | 2011-09-14 |
| 1407168131 | All Care Home Health Equipment, LLC | Durable Medical Equipment & Medical Supplies | 1000 Cooper Circle, Suite 201, Fayetteville, GA 30215 | 2010-07-10 |
| 1083854160 | Rachel Blanks | Licensed Practical Nurse | 170 Brookwood Lane, Fayetteville, GA 30215 | 2009-03-02 |
| 1093964975 | Brenda Carole Hayek | Nurse Practitioner | 735 Glynn Street S, Fayetteville, GA 30215 | 2008-09-16 |
| 1174700769 | Katheryn D. Mcdonell | Counselor | 110 Dawn Drive, Fayetteville, GA 30215 | 2008-01-25 |
| Find all providers in zip 30215 | ||||
| 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 |
|---|---|---|---|---|
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1962876128 | Melissa Jadick | Pediatrics | 135 Trotters Rdg, Fayetteville, GA 30215-6540 | 2015-11-25 |
| 1568807741 | Tequilla L Pryor | Pediatrics | 101 Yorktown Dr Ste 201, Fayetteville, GA 30214-1501 | 2013-05-01 |
| 1144508698 | Sunshine Pediatrics | Pediatrics | 514 Owen Drive, Fayetteville, NC 28304 | 2011-08-02 |
| 1922339142 | Lynn Covey Morrison | Pediatrics | 460 N Canvas Rd, Fayetteville, AR 72701-4737 | 2010-01-28 |
| 1861627226 | Kidzcare Pediatrics, PC | Pediatrics | 5617 Ramsey Street, Fayetteville, NC 28311-1423 | 2009-05-28 |
| 1053553495 | Neil A Tracy | Pediatrics | 3215 N. North Hill Road, Fayetteville, AR 72703-4424 | 2009-03-31 |
| 1932353208 | Children's Health of Carolina Dba Cumberland Children's Clinic | Pediatrics | 1738 Owen Dr Ste 107, Fayetteville, NC 28304-3419 | 2008-11-12 |
| 1588814628 | Zakiya S Karim | Pediatrics | 1327 Robeson Street, Fayetteville, NC 28305 | 2008-09-25 |
| 1043497985 | Brittany Wilson | Pediatrics | 719 Lanier Ave W, Fayetteville, GA 30214-7634 | 2008-01-22 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30215 |
Please comment or provide details below to improve the information on CAMP CREEK PEDIATRICS.
| 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.