| Village Family Care Center Pa | |
|
1248 Fort Bragg Rd Suite 200 Fayetteville NC 28305-4981 | |
| (910) 486-6818 | |
| Not Available |
| Full Name | Village Family Care Center Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1248 Fort Bragg Rd, Fayetteville, North Carolina |
| Authorized Official Name and Position | Stephanie Feilmeier (CREDENTIALING) |
| Authorized Official Contact | 8282331354 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Family Care Center Pa Po Box 1689 Etowah NC 28729-1689 Ph: (828) 891-5524 | Village Family Care Center Pa 1248 Fort Bragg Rd Suite 200 Fayetteville NC 28305-4981 Ph: (910) 486-6818 |
| NPI Number | 1346359908 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 07/05/2012 |
| Medicare PECOS PAC ID | 6002848884 |
|---|---|
| Medicare Enrollment ID | O20050831000873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346359908 | NPI | - | NPPES |
| 018EY | Other | NC | BCBS |
| 5905302 | Medicaid | NC | |
| DE6262 | Other | NC | RAILROAD PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | David R Parker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376547356 PECOS PAC ID: 7416920111 Enrollment ID: I20040819000213 |
| Provider Name | Ellen B Mclaurin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982681201 PECOS PAC ID: 6204919145 Enrollment ID: I20080214000620 |
| Provider Name | Michelle Stroup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174155683 PECOS PAC ID: 2466882451 Enrollment ID: I20200414003846 |
| Provider Name | Tara Sharay Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225671027 PECOS PAC ID: 9133463664 Enrollment ID: I20200520001676 |
| Provider Name | Lynn Chanell Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871116103 PECOS PAC ID: 2961828801 Enrollment ID: I20200821002154 |
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