Fayetteville Advanced Practitioners

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

148570 Issued in NC

Legal business name

FAYETTEVILLE ADVANCED PRACTITIONERS

Practice address

2915 Raeford Rd
Fayetteville, NC 28303-5508

Phone

(910) 670-2047

NPI assigned

Mar 6, 2014

Organization subpart

No

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

Authorized official

Name

Jamie Ann Dickerhoff, FNP-BC

Title

Nurse Practitioner, Owner

Phone

(910) 670-2047

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1629494265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28303",
            "telephone_number": "910-670-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035508",
            "telephone_number": "910-670-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE ADVANCED PRACTITIONERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "DICKERHOFF",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER, OWNER",
        "authorized_official_telephone_number": "910-670-2047",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "164680",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "148570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "245538461",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1386970572",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.