Carrie Hall Merritt, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

TL 1664 Issued in SC

Practice address

105 Stadium Oaks Dr
Clemmons, NC 27012-8962

Phone

(336) 766-0547

Fax

(366) 766-0549

NPI assigned

Jul 10, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

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.

• Forsyth Memorial Hospital, Inc.

  dba NH Forsyth Primary Care Clinics

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  Medicare reassignment Care Compare group
• Forsyth Memorial Hospital, Inc.

  dba NH Forsyth Cardiology Clinics

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1538881248
  NPD
• Forsyth Memorial Hospital, Inc.

  dba Novant Health Heart & Vascular Institute - Frontis Plaza

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1932935475
  NPD
• Beach Urgent Care

  • Urgent Care Clinic/Center
  • Myrtle Beach, SC
  • NPI 1457580474
  NPD
• Forsyth Memorial Hospital, Inc

  dba West Forsyth Internal Medicine & Pediatrics

  • Internal Medicine Physician
  • Clemmons, NC
  • NPI 1891828562

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  dba Novant Health Forsyth Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation

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

{
    "created_epoch": "1310256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1013204148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-766-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 STADIUM OAKS DR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128962",
            "telephone_number": "336-766-0547",
            "fax_number": "366-766-0549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "CARRIE",
        "middle_name": "HALL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-10",
        "last_updated": "2020-10-28",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "TL 1664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1013204148",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NCB656A",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chall117181@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "105 Stadium Oaks Dr",
            "city": "Clemmons",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270128962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Louis F McIntyre, M.D.
• Joshua Cole McKinnon, M.D.
• Sarah Willette McMillian, RPH
• Ernest Frederick McPhail III, MD
• Julie Meier
• Hannah Imwold Messer, M.D.
• Rachel Anne Meyers
• Andrea Jean Miles, MAPC, NCC
• Catherine N Miller, PA-C
• Peter John Miller, M.D.

• Physician Assistant in Clemmons, NC
• Providers in Clemmons, 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 Oct 28, 2020; 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.