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Deactivated NPI 1992362420 Deactivated / Inactive NPI Male Practitioner

Dr. Blake Allen Hoerdeman , DO

Surgery • Fayetteville, NC

✓ Accepts Medicare Assignment
⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Blake Hoerdeman has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 21, 2019
NPI Deactivation Date April 10, 2020
Total Practice Duration ~1 Years of Practice (2020 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Blake Hoerdeman, DO was a registered Surgery in Fayetteville, NC. Prior to record deactivation on 2020-04-10, Dr. Hoerdeman completed approximately 1 years of clinical practice following graduation from Pacific Nw Un Of Hs, Col Of Osteopathic Medicine in 2020.

Dr. Hoerdeman maintained professional affiliations with Cumberland County Hospital System Inc, Cape Fear Valley Health Medical Group Llc and accepted Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1638 Owen Dr

Fayetteville, NC 283043424

Telephone 9106155095
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Pacific Nw Un Of Hs, Col Of Osteopathic Medicine

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Fayetteville, NC

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -15.5 yrs vs City Avg
City Avg: 21.5 Yrs
State Avg: 24.9 Yrs
Regional Practice Density
31 Specialists

Practicing in Fayetteville, NC (1222 Statewide)

Telehealth Adoption Rate
3.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Hoerdeman (6 Years) 6 Yrs
Fayetteville Specialty Average (21.5 Years) 21.5 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-09-08
Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License NC 2025-01816

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Hospital & Practice Group Affiliations

Cape Fear Valley Health Medical Group Llc

1638 Owen Dr, Fayetteville, NC 283043424

Phone: 9106153500

Cumberland County Hospital System Inc

1841 Quiet Cv, Fayetteville, NC 283043985

Phone: 9103232626

Secondary Practice Locations

1841 Quiet Cv

Fayetteville, NC 283043985

Phone: 9109048686

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Travis Young , DO

Emergency Medicine

NPI 1013538016

Doctor of Osteopathic Medicine (D.O.)

NPI 1043212020

Doctor of Medicine (M.D.)

Reese Hofstrand

Internal Medicine

NPI 1053932947
Dr. Michael Kingberg , DO

Emergency Medicine

NPI 1073003299

Doctor of Osteopathic Medicine (D.O.)

Dr. Cody O'rear , DO

Internal Medicine

NPI 1093344830

Doctor of Osteopathic Medicine (D.O.)

Dr. Antonios Anagnostopoulos , DO

Psychiatry & Neurology - Psychiatry

NPI 1104445139

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2025

Surgery (License #2025-01816 in NC)

📍
Updated Practice Location April 22, 2020

Registered at 1638 OWEN DR, FAYETTEVILLE, NC 283043424 (Tel: 9106155095)

📍
Updated Business Mailing Address April 22, 2020

Registered at 1638 OWEN DR, FAYETTEVILLE, NC 283043424 (Tel: 9106155095)

👤
Provider Name / Credentials Updated April 22, 2020

Recorded as BLAKE HOERDEMAN, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 22, 2020

Student in an Organized Health Care Education/Training Program

⚠️
NPI Profile Deactivated April 10, 2020

Record deactivated on April 10, 2020

NPI Profile Active May 21, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location May 21, 2019

Registered at 3538 VASSAR DR, ANCHORAGE, AK 995084335 (Tel: 5412072337)

📍
Updated Business Mailing Address May 21, 2019

Registered at 3538 VASSAR DR, ANCHORAGE, AK 995084335

👤
Provider Name / Credentials Updated May 21, 2019

Recorded as BLAKE HOERDEMAN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 21, 2019

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 21, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992362420
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 21, 2019
Last Update: September 08, 2025
Deactivation Date: April 10, 2020
Sole Proprietor: No

Mailing Address

1638 Owen Dr

Fayetteville, NC 283043424

Phone: 9106155095

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.