Philip Maximilian Dayvault, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-01670 Issued in NC

Practice address

1035 Lincolnton Rd
Salisbury, NC 28144-6277

Phone

(704) 638-9990

Fax

(704) 639-0785

NPI assigned

Jan 14, 2009

Last updated

Nov 26, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

OrthocarolinaGroup PAC ID 2062316821, 288 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Orthocarolina

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1497704217
  Medicare reassignment Care Compare group
• Promed Healthcare, PLLC

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1770615114
  Medicare reassignment
• Orthocarolina

  • Orthopaedic Surgery Physician
  • Winston Salem, NC
  • NPI 1790101004
  NPD
• Orthocarolina

  • Orthopaedic Surgery Physician
  • Indian Land, SC
  • NPI 1619641453

  Physician Assistant

  NPD

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416960000000",
    "number": "1003053935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 E 4TH ST",
            "address_2": "SUITE 902",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043261",
            "telephone_number": "704-638-9990",
            "fax_number": "704-639-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 LINCOLNTON RD",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281446277",
            "telephone_number": "704-638-9990",
            "fax_number": "704-639-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAYVAULT",
        "first_name": "PHILIP",
        "middle_name": "MAXIMILIAN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-14",
        "last_updated": "2014-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daymark Recovery Services Inc
• Daymark Recovery Services Inc
• Daymark Recovery Services Inc
• Daymark Recovery Services Inc
• Daymark Recovery Services, Inc.
• Martina De Comarmond, M.D.
• Patti Deal, L.C.S.W.
• Wesley Lynn Deal, LPTA
• Cole Houston Deaver, PA-C
• Shenita Adams Deberry, AGPCNP

• Physician Assistant in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.