Joshua Pardo, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

258563 Issued in NC

Practice address

BLDG 5-4257 Bastogne Dr
Fort Liberty, NC 28310-5641

Phone

(910) 908-5835

NPI assigned

Oct 8, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1023489663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "address_2": "STE 1D03",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 5-4257 BASTOGNE DR",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283105641",
            "telephone_number": "910-908-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDO",
        "first_name": "JOSHUA",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-08",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "258563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saron Om
• Shannon Elise Ommaha, LCSW
• Ricardo Ong, M.D.
• Johnathon Owens, PA-C
• Mikayla K Paluzzi, DPT, OCS
• Jean-Francois Parent, DMD
• Courtney Pauley
• Xavier R. Pena, PSY.D.
• Talitha Roxanne Perkins, MSW, LCSW
• Ian Peters, DDS

• Medical Physician Assistant in Fort Liberty, NC
• Providers in Fort Liberty, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.