1. Home
  2. Directory
  3. North Carolina
  4. Fayetteville
  5. Psychiatry Neurology
  6. NPI Profile

RECON NEUROLOGY & PSYCHIATRY
NPI 1427769140
Psychiatry & Neurology - Neurology in Fayetteville, NC

Active since December 13, 2022CLIA Certified · 4 labs
1340 WALTER REED RD STE 202, FAYETTEVILLE, NC 28304(910) 504-3506(910) 504-3507 Get Directions Write a Review

NPPES record last updated: January 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 13, 2026, Sep 12, 2025, Aug 11, 2025 and 3 more (6 updates tracked since 2022).

About Recon Neurology & Psychiatry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RECON NEUROLOGY & PSYCHIATRY (NPI 1427769140) is a healthcare organization registered as a neurology in Fayetteville, North Carolina and active in the NPI registry since December 2022. The organization holds 4 active CLIA laboratory certificates, maintains 4 additional practice locations, and lists Lisa Hudson, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1427769140
Entity TypeOrganization
Primary Taxonomy2084N0400X
Legal Business NameRECON NEUROLOGY & PSYCHIATRY
Location Address1340 WALTER REED RD STE 202Fayetteville, NC 28304-4451
Mailing Address1340 Walter Reed Rd Ste 202Fayetteville, NC 28304-4451 · (910) 504-3506 · Fax (910) 504-3507
Phone(910) 504-3506
Fax(910) 504-3507
Organization SubpartNo
Authorized OfficialLisa HudsonCredentialing Coordinator · (910) 372-6172
Enumeration DateDecember 13, 2022
Last NPPES UpdateJanuary 13, 20266 updates tracked since enumeration
NPPES CertifiedJanuary 13, 2026
✔ NPI 1427769140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
1340 WALTER REED RD STE 202, Fayetteville, NC 28304
Open in Google Maps ↗

Secondary Practice Locations 4

Location 13656 Cape Center DrFayetteville, NC 28304-4406 · Phone (910) 504-3506 · Fax (910) 504-3507
Location 270 Memorial DrPinehurst, NC 28374-1102 · Phone (910) 348-1192 · Fax (910) 348-1193
Location 31357 Walter Reed Rd Ste 101Fayetteville, NC 28304-4417 · Phone (910) 504-3506 · Fax (910) 504-3507
Location 4401 79th Ave NMyrtle Beach, SC 29572-4310 · Phone (843) 948-1191 · Fax (843) 948-1192

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Molina Healthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D2333119

Recon Neurology & Psychiatry · Myrtle Beach, SC
Active · expires Oct 29, 2027
CLIA Number42D2333119
Laboratory TypePhysician Office
Certificate Effective DateOctober 30, 2025
Certificate Expiration DateOctober 29, 2027
Laboratory DirectorMatthew K. Banks
Laboratory Phone(843) 948-1191
Laboratory LocationRecon Neurology & Psychiatry401 79th Avenue N, Myrtle Beach, SC 29572
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2273924

Recon Neurology & Psychiatry · Fayetteville, NC
Active · expires Dec 20, 2026
CLIA Number34D2273924
Laboratory TypePhysician Office
Certificate Effective DateDecember 21, 2024
Certificate Expiration DateDecember 20, 2026
Laboratory DirectorDr. Matthew K. Banks
Laboratory Phone(910) 504-3506
Laboratory LocationRecon Neurology & Psychiatry1340 Walter Reed Road, Ste 202, Fayetteville, NC 28304
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2309874

Recon Neurology & Psychiatry · Fayetteville, NC
Active · expires Aug 21, 2026
CLIA Number34D2309874
Laboratory TypePhysician Office
Certificate Effective DateAugust 22, 2024
Certificate Expiration DateAugust 21, 2026
Laboratory DirectorMatthew K. Banks
Laboratory Phone(910) 504-3506
Laboratory LocationRecon Neurology & Psychiatry1357 Walter Reed Road, Ste 101, Fayetteville, NC 28304
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 34D2334380

Recon Neurology And Psychiatry · Pinehurst, NC
Active · expires Nov 19, 2027
CLIA Number34D2334380
Laboratory TypePhysician Office
Certificate Effective DateNovember 20, 2025
Certificate Expiration DateNovember 19, 2027
Laboratory DirectorMatthew K. Bank
Laboratory Phone(843) 948-1191
Laboratory LocationRecon Neurology And Psychiatry70 Memorial Drive, Pinehurst, NC 28374
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. PAMELA LYNN HERBIG WALL PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
1340 WALTER REED RD STE 202
FAYETTEVILLE, NC 28304
Cumberland County (910) 504-3506
DERRICK BIELLER PA-C
Physician Assistant
1340 WALTER REED RD STE 202
FAYETTEVILLE, NC 28304
Cumberland County (910) 504-3506
MR. CHRISTOPHER CHARLES PRICE-CUNNINGHAM PA-C
Physician Assistant (Medical)
1340 WALTER REED RD STE 202
FAYETTEVILLE, NC 28304
Cumberland County (910) 504-3506
MS. LISA ANN DEISCH PA-C
Physician Assistant
1340 WALTER REED RD STE 202
FAYETTEVILLE, NC 28304
Cumberland County (910) 504-3506
CHERYL H DODSON DNP, APRN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1340 WALTER REED RD STE 202
FAYETTEVILLE, NC 28304
Cumberland County (910) 504-3506
MYRANDA-LYNN MARIE BODY LCSW
Social Worker (Clinical)
1340 WALTER REED RD STE 202
FAYETTEVILLE, NC 28304
Cumberland County (910) 504-3506
TARA C. BROUSE PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1340 WALTER REED RD STE 202
FAYETTEVILLE, NC 28304
Cumberland County (910) 504-3506
DR. NGU WAH AUNG M.D
Psychiatry & Neurology (Psychiatry)
1340 WALTER REED RD STE 202
FAYETTEVILLE, NC 28304
Cumberland County (910) 504-3506

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Recon Neurology & Psychiatry's NPI number?

The NPI number for Recon Neurology & Psychiatry is 1427769140. It was assigned to this organization in the NPPES registry on December 13, 2022.

Where is Recon Neurology & Psychiatry located?

Recon Neurology & Psychiatry is located at 1340 Walter Reed Rd Ste 202, Fayetteville, NC 28304. The listed phone number is (910) 504-3506.

What is Recon Neurology & Psychiatry's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Does Recon Neurology & Psychiatry hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Recon Neurology & Psychiatry accept?

Health plans from Blue Cross and Blue Shield of NC and Molina Healthcare list Recon Neurology & Psychiatry as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Recon Neurology & Psychiatry was last updated on January 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.