MRS. CAROL JEANETTE FAIRCHILD (NPI# 1972565547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972565547 |
| Entity Type | Individual |
| Full Name | MRS. CAROL JEANETTE FAIRCHILD |
| Credential | ARNP |
| Practice Address |
2020 Commerce Dr Melbourne FL 32904-2335 |
| Mailing Address |
400 East Sheridan Rd Melbourne FL 32901-3122 |
| Practice Telephone | 3219526000 |
| Practice Fax Number | 3216373648 |
| Mailing Telephone | 3217225200 |
| Mailing Fax Number | 3216373648 |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2017-04-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
ARNP299262 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992853782 | Carol Fairchild | Physical Therapy Assistant | 201 Kimberly Ln, Williamstown, KY 41097-9458 | 2007-01-08 |
| Street Address |
2020 COMMERCE DR |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32904-2335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144793407 | Kelly Fuller | Nurse Practitioner | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2019-01-09 |
| 1952741845 | Stephanie Dean Fish | Registered Nurse | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2013-06-25 |
| 1164725933 | Tanisha Campbell | Licensed Practical Nurse | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2010-12-16 |
| 1538362439 | David Cyrus Ray | Pharmacist | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2007-06-07 |
| 1023141033 | Sheila Ponce | Psychologist | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2007-03-13 |
| 1598807059 | Sarah Tyler | Social Worker | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2007-02-13 |
| 1245371160 | James Braun | Counselor | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2007-02-12 |
| 1285775122 | Patti Diane Gibbons | Counselor | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2007-02-12 |
| 1295876035 | Harry Hillmer | Counselor | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2007-02-12 |
| 1558402446 | Mary Allen | Counselor | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2007-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063066512 | Shepherd's Heart Ministries | Counselor | 900 S Wickham Rd, Melbourne, FL 32904 | 2019-08-01 |
| 1588138663 | Nicholle C Rothengass | Physician Assistant | 2263 W New Haven Ave # 350, W Melbourne, FL 32904 | 2019-01-11 |
| 1114407020 | Natalie Havkin | Speech-Language Pathologist | 250 S Wickham Rd., Melbourne, FL 32904 | 2018-08-20 |
| 1184119299 | Marni B Simon | Speech-Language Pathologist | 565 Acacia Ave, Melbourne Village, FL 32904 | 2018-06-30 |
| 1821588625 | Walden Psychological Services, LLC | Psychologist | 3400 Willowwood Dr, Melbourne, FL 32904 | 2018-05-16 |
| 1598276271 | Donetta Gwin Reynolds | Early Intervention Provider Agency | 764 Triples Crown Lane, West Melbourne, FL 32904 | 2017-10-20 |
| 1598205221 | Marathon Health, LLC | General Practice | 2550 Wingate Boulevard, C/o Brevard Wellcare- South, West Melbourne, FL 32904 | 2017-02-28 |
| 1366875387 | Cancer Center of Melbourne LLC | Clinic/Center | 415 S. Wickham Rd., Melbourne, FL 32904 | 2013-08-13 |
| 1558704312 | Sandra Suzanne Borthwick | Social Worker | 569 Sylvia Rd, Melbourne, FL 32904 | 2013-04-11 |
| 1396983607 | Genesis | Skilled Nursing Facility | 2653 Reflections Pl, W. Melbourne, FL 32904 | 2009-01-23 |
| Find all providers in zip 32904 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104304161 | Nicolina Demuynck | Nurse Practitioner | 6767 N Wickham Rd Ste 306, Melbourne, FL 32940-2025 | 2018-08-01 |
| 1467771006 | Terri Pesante | Nurse Practitioner | 400 E. Sheridan Rd, Melbourne, FL 32901 | 2010-05-21 |
| 1417583998 | Thomas Smura | Nurse Practitioner | 400 East Sheridan Rd, Melbourne, FL 32901 | 2020-03-17 |
| 1306479399 | Jessica Matos | Nurse Practitioner | 2120 Sarno Rd, Melbourne, FL 32935-3084 | 2020-02-18 |
| 1144793407 | Kelly Fuller | Nurse Practitioner | 2020 Commerce Dr, Melbourne, FL 32904-2335 | 2019-01-09 |
| 1245453471 | Mary Ann Barnett | Nurse Practitioner | 2340 Dairy Rd, Suite 104, Melbourne, FL 32904-5210 | 2007-04-10 |
| 1942364138 | Karen Suzanne Berkley | Nurse Practitioner | 400 East Sheridan Rd, Melbourne, FL 32901-3122 | 2006-12-21 |
| 1790728616 | Rebecca Biggin | Nurse Practitioner | 400 E Sheridan Rd, Melbourne, FL 32901-3122 | 2006-06-14 |
| 1568405090 | Nancy Thompson | Nurse Practitioner | 400 E Sheridan Rd, Melbourne, FL 32901-3122 | 2006-06-13 |
| 1114960796 | Mari Aldeghi | Nurse Practitioner | 400 E Sheridan Rd, Melbourne, FL 32901-3122 | 2006-06-13 |
| Find all providers in MELBOURNE | ||||
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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.