Recon Neurology & Psychiatry

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

RECON NEUROLOGY & PSYCHIATRY

Practice address

1340 Walter Reed Rd Ste 202
Fayetteville, NC 28304-4451

Phone

(910) 504-3506

Fax

(910) 504-3507

NPI assigned

Dec 13, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa Hudson

Title

Credentialing Coordinator

Phone

(910) 372-6172

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GBCJCD

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ngu Wah Aung, M.D

  • Psychiatry Physician
  • Fayetteville, NC
  • NPI 1760741961

  SC

  Medicare reassignment Care Compare group NPD
• Matthew Banks, DO

  • Neurology Physician
  • Fayetteville, NC
  • NPI 1659772069

  SC

  Medicare reassignment Care Compare group NPD
• Derrick Bieller, PA-C

  • Physician Assistant
  • Fayetteville, NC
  • NPI 1063982734
  Medicare reassignment Care Compare group NPD
• Sheila Lane Blanks, FNP

  • Family Nurse Practitioner
  • Fayetteville, NC
  • NPI 1184985335
  Medicare reassignment Care Compare group NPD
• Myranda-Lynn Marie Body, LCSW

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1417716283
  Medicare reassignment Care Compare group NPD
• Cheryl H Dodson, DNP, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fayetteville, NC
  • NPI 1386452837
  Medicare reassignment Care Compare group NPD
• Jessica Wood Fleishman

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1679288260
  Medicare reassignment Care Compare group NPD
• Pamela Lynn Herbig Wall, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fayetteville, NC
  • NPI 1033386446
  Medicare reassignment Care Compare group NPD
• Marisa Kawabe

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1821666140
  Medicare reassignment Care Compare group NPD
• Rudi Marshae Mack, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Pinehurst, NC
  • NPI 1881573855
  Medicare reassignment Care Compare group NPD
• Elizabeth Leah Monis, DO

  • Psychiatry Physician
  • Pinehurst, NC
  • NPI 1750901484

  Neurology

  Medicare reassignment Care Compare group NPD
• Felix Ijeoma Nwajei, MD PHD

  • Neurology Physician
  • Fayetteville, NC
  • NPI 1376021279
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1427769140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 WALNUT KNOLL LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380183113",
            "telephone_number": "901-756-5565",
            "fax_number": "901-156-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 WALTER REED RD STE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044451",
            "telephone_number": "910-504-3506",
            "fax_number": "910-504-3507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Pinehurst",
            "state": "NC",
            "postal_code": "283748707",
            "country_code": "US",
            "telephone_number": "910-348-1192",
            "fax_number": "910-348-1193",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 79th Ave N",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295724310",
            "country_code": "US",
            "telephone_number": "843-948-1191",
            "fax_number": "843-948-1192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1357 Walter Reed Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283044417",
            "country_code": "US",
            "telephone_number": "910-504-3506",
            "fax_number": "910-504-3507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3656 Cape Center Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283044406",
            "country_code": "US",
            "telephone_number": "910-504-3506",
            "fax_number": "910-504-3507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RECON NEUROLOGY & PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-13",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "910-372-6172"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elliott Rebello, MD
• Rebirth-Heart and Mind PLLC
• Reboot Behavioral Health PLLC
• Sarah Elizabeth Rebrassier, DO
• Reclaim Counseling Services
• Recovery Innovations, Inc (RI International)
• Aaliyah Redder
• Sirisha Pasham Reddy, MD
• Redeeming Life Counseling and Consulting, PLLC
• Dana Rednour, PT

• Neurology Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Neurology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.