| Cedar Oaks Clinic Pllc | |
|
1748 Heritage Center Dr Ste 101 Wake Forest NC 27587-9855 | |
| (919) 332-8969 | |
| Not Available |
| Full Name | Cedar Oaks Clinic Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1748 Heritage Center Dr Ste 101, Wake Forest, North Carolina |
| Authorized Official Name and Position | Cedar Oaks Clinic (CLINIC) |
| Authorized Official Contact | 9195295920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Oaks Clinic Pllc 1748 Heritage Center Dr Ste 101 Wake Forest NC 27587-9855 Ph: () - | Cedar Oaks Clinic Pllc 1748 Heritage Center Dr Ste 101 Wake Forest NC 27587-9855 Ph: (919) 332-8969 |
| NPI Number | 1184209470 |
|---|---|
| Provider Enumeration Date | 03/17/2021 |
| Last Update Date | 02/01/2022 |
| Certification Date | 02/01/2022 |
| Medicare PECOS PAC ID | 0547678500 |
|---|---|
| Medicare Enrollment ID | O20210413001294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184209470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Amber Emery Remington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902228935 PECOS PAC ID: 3476784638 Enrollment ID: I20140401001414 |
| Provider Name | Katrina Mccourt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063810711 PECOS PAC ID: 5799098356 Enrollment ID: I20150725012649 |
| Provider Name | Kondal Madaram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003952144 PECOS PAC ID: 4284826892 Enrollment ID: I20160718001619 |
| Provider Name | Launiece D Newton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750881983 PECOS PAC ID: 9436412087 Enrollment ID: I20180411002934 |
| Provider Name | Natasha Jane Donnelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790387447 PECOS PAC ID: 1557776721 Enrollment ID: I20210413001441 |
| Provider Name | Tracy Leigh Schofield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205550407 PECOS PAC ID: 5092185280 Enrollment ID: I20230104002060 |
| Provider Name | Shari Lynn Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346931953 PECOS PAC ID: 0244699437 Enrollment ID: I20230706001979 |
| Provider Name | Jaime Havah Eliana Michaels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710727243 PECOS PAC ID: 5799222667 Enrollment ID: I20240809000491 |
| Provider Name | Margaret Goris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144595828 PECOS PAC ID: 9537321773 Enrollment ID: I20250107004042 |
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