EDEN INTERNAL MEDICINE PLLC (NPI# 1275773954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275773954 |
| Entity Type | Organization |
| Organization Name | EDEN INTERNAL MEDICINE PLLC |
| Practice Address |
405 Thompson St Eden NC 27288-5045 |
| Practice Telephone | 3366274896 |
| Practice Fax Number | 3366270139 |
| Mailing Telephone | 3366274896 |
| Mailing Fax Number | 3366270139 |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2009-02-20 |
| Authorized Official Name | MS. ANGELA MARIE RAYMER (PHYSICIAN ASSISTANT CERTIFIED) |
| Authorized Official Telephone | 3366274896 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-01723 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730288895 | Eden Internal Medicine Pllc | Internal Medicine | 405 Thompson St, Eden, NC 27288-5045 | 2006-09-22 |
| Street Address |
405 THOMPSON ST |
| City | EDEN |
| State | NC |
| Zip Code | 27288-5045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023079043 | Keavie C. Hairfield | Nurse Practitioner | 405 Thompson St, Eden, NC 27288-5045 | 2006-03-29 |
| 1619522414 | Taylor Beth Woodson | Nurse Practitioner | 405 Thompson St, Eden, NC 27288-5045 | 2019-08-08 |
| 1821641002 | Mackenzie Barham | Nurse Practitioner | 405 Thompson St, Eden, NC 27288-5045 | 2019-07-17 |
| 1225454507 | Angela Renee Boone | Nurse Practitioner | 405 Thompson St, Eden, NC 27288-5045 | 2014-03-11 |
| 1730288895 | Eden Internal Medicine Pllc | Internal Medicine | 405 Thompson St, Eden, NC 27288-5045 | 2006-09-22 |
| 1730287020 | Ashish C Shah | Internal Medicine | 405 Thompson St, Eden, NC 27288-5045 | 2006-09-20 |
| 1437257706 | Dhruv B Vyas | Internal Medicine | 405 Thompson St, Eden, NC 27288-5045 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639781297 | Bailey Shea Scism | Pharmacist | 103 W Stadium Dr., Eden, NC 27288 | 2020-08-17 |
| 1538640628 | Donnell Corey Brown Jr. | Technician | 519 Orchard Drive, Eden, NC 27288 | 2018-08-27 |
| 1851728182 | Linda Mitchell | Physical Therapy Assistant | 114 E Kings Hwy, Eden, NC 27288 | 2013-10-01 |
| 1033341573 | Central State of The Carolinas, Inc. | Day Training, Developmentally Disabled Services | 229 Cedar St., Eden, NC 27288 | 2009-08-18 |
| 1114186483 | Enrich Cosmetic Center | Internal Medicine | 406 B Thompson St, Eden, NC 27288 | 2008-06-03 |
| 1265630891 | John R. Dabbs Jr. Dc PC | Preferred Provider Organization | 405 Boone Road, Eden, NC 27288 | 2007-07-05 |
| 1235283961 | James Harrison Eggleston | Dentist | 113 West Arbor Lane, Eden, NC 27288 | 2007-01-22 |
| 1962563940 | Barbara Collins Tanner | Nurse Practitioner | 134 North Pierce Street, Morehead High School Student Health Center, Eden, NC 27288 | 2006-12-13 |
| 1285690974 | Robert Maurice Vaughn | Chiropractor | 405 Boone Rd, Eden, NC 27288 | 2006-04-22 |
| 1619930666 | Direct Respiratory Services | Durable Medical Equipment & Medical Supplies | 302a North Pierce Street, Eden, NC 27288 | 2006-04-10 |
| Find all providers in zip 27288 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447252648 | William S Boyd | Physician Assistant | 250 W Kings Hwy, Eden, NC 27288-5010 | 2005-06-01 |
| 1801400353 | Alyssa Horton | Physician Assistant | 250 W Kings Hwy, Eden, NC 27288-5010 | 2020-09-02 |
| 1649815283 | Jakalyn Jane Gossett | Physician Assistant | 614 Eaker St, Eden, TX 76837 | 2019-11-07 |
| 1629549852 | Jesse Robert Gustafson | Physician Assistant | 117 E Kings Hwy, Eden, NC 27288-5201 | 2018-12-16 |
| 1356718712 | Alyssa Michelle Allwardt | Physician Assistant | 250 W Kings Hwy, Eden, NC 27288-5010 | 2015-09-01 |
| 1447673975 | Tiffany Gann | Physician Assistant | 519 S Van Buren Rd, Suite C, Eden, NC 27288-5070 | 2014-02-04 |
| 1215968763 | Eugene Carmelo Serpe | Physician Assistant | 518 S Van Buren Rd, Ste 3, Eden, NC 27288-5033 | 2006-07-05 |
| 1558363754 | Amy H Boyd | Physician Assistant | 250 W Kings Hwy, Eden, NC 27288-5010 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538459 | Sarah Jane Lamanna | Physician Assistant | 3012 Bristol Creek Dr, Morrisville, NC 27560-7811 | 2020-11-04 |
| 1043819741 | Brad Russell Tolan | Physician Assistant | 211 Pinegate Cir Apt 12, Chapel Hill, NC 27514-2221 | 2020-10-22 |
| 1265030654 | Vanessa Vinson | Physician Assistant | 284 Lower Edgewood Rd, Candler, NC 28715-9285 | 2020-10-16 |
| 1649878810 | Courtney Michelle Watlington | Physician Assistant | 360 N Bennett St, Southern Pines, NC 28387-4813 | 2020-10-11 |
| 1669079034 | Christine Meyer | Physician Assistant | 2523 Creek Ridge Ln, Chapel Hill, NC 27514-7454 | 2020-10-07 |
| 1407453319 | Khyan Waddell | Physician Assistant | 127 Sneed Rd, Enfield, NC 27823-9589 | 2020-10-04 |
| 1053918979 | Amjad Ali | Physician Assistant | 730 Montlieu Ave, High Point, NC 27260-4000 | 2020-10-04 |
| 1104433382 | Aditi Bhattacharjee Sundaresan | Physician Assistant | 131 Mallard Ct, Chapel Hill, NC 27517-9104 | 2020-09-30 |
| 1689281933 | Kathryn Tarulli | Physician Assistant | 600 W Main St Apt 624, Durham, NC 27701-5005 | 2020-09-29 |
| 1205443991 | Kelsey Mendez | Physician Assistant | 105 Basket Oak Dr, Bunnlevel, NC 28323-9141 | 2020-09-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.