Individual provider Active NPI

Laura Beth Moraitis, PA

  • Physician Assistant
  • Lewisville, NC
National Provider Identifier
1043388739
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-02053 Issued in NC
Practice address
165 Lowes Foods Dr
Lewisville, NC 27023-8258
Phone
(336) 893-2270
Fax
(336) 893-2279
NPI assigned
Dec 1, 2006
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 724 AK
Physician Assistant 363A00000X 0010-02053 NC Primary
Medical Physician Assistant 363AM0700X 0010-02053 NC
Internal Medicine Physician 207R00000X 0010-02053 NC

Addresses

Primary practice location

165 Lowes Foods Dr
Lewisville, NC 27023-8258

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

2511 Old Cornwallis Rd Ste 200
Durham, NC 27713-1869
Phone (919) 932-5700

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091209000601 NC Practitioner - Physician Assistant 8729089412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

165 Lowes Foods Dr
Lewisville, NC 27023-8258
Phone (336) 893-2270

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4572

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
724AKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jun 1, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 1, 2024 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

121 Medical Dr
Advance, NC 27006
Phone (336) 940-2407

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

165 Lowes Foods Dr
Lewisville, NC 27023
Phone (336) 893-2270

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: lmoraitis1574061@direct.novanthealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1043388739",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 LOWES FOODS DR",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270238258",
            "telephone_number": "336-893-2270",
            "fax_number": "336-893-2279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2511 Old Cornwallis Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277131869",
            "country_code": "US",
            "telephone_number": "919-932-5700",
            "fax_number": "919-933-6881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAITIS",
        "first_name": "LAURA",
        "middle_name": "BETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "724",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02053",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02053",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "0010-02053",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, NC

Sources for this page

Verify at the official NPI Registry.