NPIMap

Individual provider Active NPI

Blake Allen Hoerdeman, DO

  • Surgery Physician
  • Fayetteville, NC
National Provider Identifier
1992362420
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2025-01816 Issued in NC
Practice address
1638 Owen Dr
Fayetteville, NC 28304-3424
Phone
(910) 615-5095
NPI assigned
May 21, 2019
Reactivated
Apr 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2025-01816 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1638 Owen Dr
Fayetteville, NC 28304-3424

Mailing address

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-5095

Other practice location 1

1841 Quiet Cv
Fayetteville, NC 28304-3985
Phone (910) 904-8686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250903001556 NC Practitioner - General Surgery 3779905336 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cape Fear Valley Health Medical Group LLCGroup PAC ID 0648707109, 352 clinicians
Cumberland County Hospital System IncGroup PAC ID 1850204041, 581 clinicians

Practice addresses (Care Compare)

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-3500

1841 Quiet CV
Fayetteville, NC 28304-3985
Phone (910) 323-2626

Hospital & facility affiliations

  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025-01816NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland County Hospital System Inc Current Accepting new patients
Cape Fear Valley Health Medical Group LLC CurrentSince Dec 14, 2025 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Aug 11, 2025 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Aug 11, 2025 Accepting new patients
Cape Fear Valley Health Medical Group LLC CurrentSince Dec 14, 2025 Accepting new patients

Locations

1638 Owen Dr
#138
Fayetteville, NC 28304
Phone (910) 615-4530

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

1841 Quiet Cv
Fayetteville, NC 28304
Phone (910) 323-2626

4140 Ferncreek Dr
Ste 801
Fayetteville, NC 28314
Phone (910) 484-2171

Interoperability endpoints

  • Direct secure messaging: bhoerdeman80253@capefearvalley.direct-ci.com

Organizations & group practices 6

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

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1992362420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-5095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1841 Quiet Cv",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043985",
            "country_code": "US",
            "telephone_number": "910-904-8686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOERDEMAN",
        "first_name": "BLAKE",
        "middle_name": "ALLEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-21",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "deactivation_date": "2020-04-10",
        "reactivation_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2025-01816",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.