CAROLINA NICK (NPI# 1417433145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417433145 |
| Entity Type | Individual |
| Full Name | CAROLINA NICK |
| Credential | PA |
| Practice Address |
205 Page Rd Pinehurst NC 28374-8749 |
| Practice Telephone | 9102353330 |
| Mailing Telephone | 9102353330 |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2020-08-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-08076 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MEDICAL LICENSE | 0010-08076 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1813 Richmond Ave, Port Royal, SC 299352014 | 8438374400 | |
| 25 Hospital Center Cmns Ste 200, Hilton Head Island, SC 299262841 | 8438374400 |
| Street Address |
205 PAGE RD |
| City | PINEHURST |
| State | NC |
| Zip Code | 28374-8749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497745525 | David John Kersbergen | Family Medicine | 205 Page Rd, Pinehurst, NC 28374-8749 | 2005-10-28 |
| 1770192700 | Jennifer Taylor Reid | Nurse Practitioner | 205 Page Rd, Pinehurst, NC 28374-8798 | 2020-07-27 |
| 1477188019 | Laura Jo Love | Nurse Practitioner | 205 Page Rd, Pinehurst, NC 28374-8749 | 2020-03-04 |
| 1265902852 | Chelsea Marie Fairley | Physician Assistant | 205 Page Rd, Pinehurst, NC 28374 | 2018-11-27 |
| 1295262103 | Mcpc-18, LLC | Internal Medicine | 205 Page Rd, Pinehurst, NC 28374-8749 | 2017-05-23 |
| 1447782776 | Gail C. Lowery | Nurse Practitioner | 205 Page Rd, Pinehurst, NC 28374-8749 | 2017-03-27 |
| 1275072753 | Skyler W Rogers | Nurse Practitioner | 205 Page Rd, Pinehurst, NC 28374 | 2017-02-17 |
| 1902356579 | Sara K Erdwins | Physician Assistant | 205 Page Rd, Pinehurst, NC 28374-8749 | 2016-10-07 |
| 1235688284 | Savannah M Fodero | Nurse Practitioner | 205 Page Rd, Pinehurst, NC 28374-8749 | 2016-09-30 |
| 1144779331 | Rebecca E Pettigrew | Physician Assistant | 205 Page Rd, Pinehurst, NC 28374-8749 | 2016-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841855160 | Ashley Nicole Jimenez | Registered Nurse | 120 Applecross Rd. Suite #2, Suite #2, Pinehurst, NC 28374 | 2019-05-02 |
| 1063076552 | Lesley Anne Pritchard | Physician Assistant | 5 Pine Tree Road, Unit 208, Pinehurst, NC 28374 | 2019-04-30 |
| 1477003697 | Whitney Byrd Franco | Counselor | 325 Page Rd Bldg 3, Pinehurst, NC 28374 | 2016-10-12 |
| 1649678715 | Laura Davies | Counselor | 105 Bradfordf Village Court, Bradford Associates Nc LLC, Southern Pines, NC 28374 | 2014-12-05 |
| 1942611280 | Ann Marie Toebes Richards | Family Medicine | 150 Ivey Lane, Suite B, Pinehurst, NC 28374 | 2014-05-08 |
| 1912328329 | Rebekah Thomas Wood | Behavioral Analyst | 350 Diamondhead Dr S, Pinehurst, NC 28374 | 2014-01-02 |
| 1558643015 | Michael A Rohrer | Prosthetist | 95 Aviemore Drive, Pinehurst, NC 28374 | 2011-09-12 |
| 1861799199 | Quality Care Pharmacy of The Sandhills | Pharmacy | 65 Parker Lane, Pinehurst, NC 28374 | 2011-02-23 |
| 1750681185 | Robin G Cummings | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 360 Tall Timbers Drive, Pinehurst, NC 28374 | 2010-11-02 |
| 1942523402 | Laura Schramm Kuzma | Counselor | 25 Chinquapin Rd., Suite 3b, Pinehurst, NC 28374 | 2010-03-11 |
| Find all providers in zip 28374 | ||||
| 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 |
|---|---|---|---|---|
| 1205481660 | Franky Lee Stooksbury Jr. | Physician Assistant | 120 Applecross Rd Ste 2, Pinehurst, NC 28374-8520 | 2019-08-02 |
| 1063076552 | Lesley Anne Pritchard | Physician Assistant | 5 Pine Tree Road, Unit 208, Pinehurst, NC 28374 | 2019-04-30 |
| 1275025793 | David Manning | Physician Assistant | 285 Olmsted Blvd Ste 1, Pinehurst, NC 28374-9021 | 2018-05-31 |
| 1255682449 | Ashraf Kobeissi | Physician Assistant | 150 Ivey Ln Ste A, Pinehurst, NC 28374-9817 | 2012-09-27 |
| 1073894994 | Keith Daniel Harris | Physician Assistant | 32 Beryl Cir, Pinehurst, NC 28374-9128 | 2011-09-06 |
| 1538447081 | Alicia S Libby | Physician Assistant | Outpatient Cancer Center, 220 Page Road, Pinehurst, NC 28374-3000 | 2011-08-02 |
| 1982910097 | Orlinda A Martinez | Physician Assistant | 305 Page Rd, Suite 1, Pinehurst, NC 28374-8751 | 2010-08-26 |
| 1881831972 | Amy Gonzales | Physician Assistant | 10 Page Dr, Pinehurst, NC 28374-8848 | 2009-01-12 |
| 1194719013 | Stacy Leigh Murphy Marcum | Physician Assistant | 15 Regional Dr, Pinehurst, NC 28374-8850 | 2005-09-07 |
| 1588296826 | Lauren Alexa Williams | Physician Assistant | 35 Memorial Dr, Pinehurst, NC 28374-8708 | 2020-02-05 |
| Find all providers in PINEHURST | ||||
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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.