BREEZEWOOD HEALTHCARE P A (NPI# 1902212541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902212541 |
| Entity Type | Organization |
| Organization Name | BREEZEWOOD HEALTHCARE P A |
| Practice Address |
200 Forsythe St Fayetteville NC 28303-5426 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 9104850700 |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2014-07-03 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 30552 | NC | Suppliers |
| Street Address |
200 FORSYTHE ST |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-5426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748562 | Gerianne C Geszler | Obstetrics & Gynecology | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2005-05-23 |
| 1962954487 | Total Approach Wellness & Aesthetics | Clinic/Center | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2016-11-01 |
| 1821467044 | Prana Health Pllc | Psychiatry & Neurology | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2015-09-17 |
| 1023337276 | Breezewood Healthcare, P.a. | General Practice | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2010-05-27 |
| 1215175559 | The Center for Health and Restoration, Inc. | General Practice | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2009-01-23 |
| 1356404453 | Breezewood Family Healthcare, Pa | Family Medicine | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2006-12-19 |
| 1952481830 | Cynthia C Phillips | Physician Assistant | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2006-10-16 |
| 1821038209 | Rahul Kumar Kakkar | Internal Medicine | 200 Forsythe St, Fayetteville, NC 28303-5426 | 2006-06-07 |
| 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 | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114437985 | Physician Comp Rx, LLC | Non-Pharmacy Dispensing Site | 540 E Appleby Rd Ste 104, Fayetteville, AR 72703-4114 | 2017-10-06 |
| 1336554153 | Urgent Cares of America Nc Inc | Non-Pharmacy Dispensing Site | 4401 Ramsey St, Suite 104, Fayetteville, NC 28311-2202 | 2014-07-01 |
| 1174955249 | Planned Parenthood of Central North Carolina, Inc. | Non-Pharmacy Dispensing Site | 4551 Yadkin Rd, Fayetteville, NC 28303-3421 | 2013-07-31 |
| 1205174141 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 3007 Town Center Dr, 100-101, Fayetteville, NC 28306-3639 | 2013-01-28 |
| 1922255884 | Fayetteville Primary Care | Non-Pharmacy Dispensing Site | 1673 Owen Dr, Fayetteville, NC 28304-3425 | 2008-08-22 |
| 1841531662 | Fayetteville Medical Clinic | Non-Pharmacy Dispensing Site | 3613 Raeford Rd, Suite B, Fayetteville, NC 28304-2113 | 2013-03-04 |
| 1700137791 | Merrell Foot Clinic, PC | Non-Pharmacy Dispensing Site | 2250 Thornton Taylor Pkwy, Suite B, Fayetteville, TN 37334-3651 | 2012-10-01 |
| 1700191186 | Cumberland Medical Associates | Non-Pharmacy Dispensing Site | 5085 Morganton Rd, 100, Fayetteville, NC 28314-1523 | 2010-08-10 |
| 1174747711 | Blood and Cancer Clinic, Pa | Non-Pharmacy Dispensing Site | 2125 Valleygate Dr, Suite 101, Fayetteville, NC 28304-3657 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952775108 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 907 Us 401 Bypass, Laurinburg Commons, Laurinburg, NC 28352 | 2015-11-25 |
| 1417321381 | Urgent Cares of America Nc Inc | Non-Pharmacy Dispensing Site | 5214 Market St, Wilmington, NC 28405-4067 | 2015-11-16 |
| 1003280033 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 825 Blowing Rock Blvd, Lenoir, NC 28645-3709 | 2015-11-13 |
| 1659741361 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 1262 East Broad Avenue, Rockingham, NC 28379 | 2015-10-07 |
| 1740650456 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 220 Us Highway 70 West, Garner, NC 27529 | 2015-10-07 |
| 1033589072 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 6010 Glenwood Ave, Raleigh, NC 27612-2602 | 2015-10-02 |
| 1922478205 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 910 N Madison Blvd, Suite B, Roxboro, NC 27573-4573 | 2015-09-30 |
| 1942679519 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 511 Smoky Park Hwy, Candler, NC 28715-8613 | 2015-09-24 |
| 1164891016 | Urgent Cares of America North Carolina Inc | Non-Pharmacy Dispensing Site | 212 N Spence Ave, Goldsboro, NC 27534-4318 | 2015-09-22 |
| 1811363674 | Unc Physicians Network, LLC | Non-Pharmacy Dispensing Site | 7100-9 Kit Creek Road, Research Triangle Park, NC 27709 | 2015-08-17 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
Please comment or provide details below to improve the information on BREEZEWOOD HEALTHCARE P A.
| 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.