Individual provider Active NPI

Jerold J Fadem Jr., M.D.

  • Internal Medicine Physician
  • Asheville, NC
National Provider Identifier
1629046958
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME40519 Issued in FL
Practice address
1100 Tunnel Rd
Asheville, NC 28805-2576
Phone
(828) 202-2735
NPI assigned
Mar 11, 2006
Last updated
May 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME40519 FL Primary

Addresses

Primary practice location

1100 Tunnel Rd
Asheville, NC 28805-2576

Mailing address

1100 Tunnel Rd
Asheville, NC 28805-2576
Phone (828) 202-2735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210630000722 NC Order and Referring Only - Family PracticePractitioner - Family Practice 4789619990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Injury East, Inc Internal Medicine Current Accepting new patients
Central Florida Injury & Rehabilitation, Inc Internal Medicine Current Accepting new patients
Central Florida Injury Southwest, Inc Internal Medicine Current Accepting new patients
Primedoc Park Ridge PA Internal Medicine Past Accepting new patients
Rutherford Internal Medicine Associates PA Internal Medicine Past Accepting new patients
Rutherford Internal Medicine Associates PA Internal Medicine Past Accepting new patients
Prime Doc of Haywood, PA Internal Medicine Past Accepting new patients

Locations

882 S Kirkman Rd
Ste 101
Orlando, FL 32811
Phone (407) 578-2350

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1629046958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 TUNNEL RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288052576",
            "telephone_number": "828-202-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 TUNNEL RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288052576",
            "telephone_number": "828-202-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADEM",
        "first_name": "JEROLD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-11",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME40519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.