Individual provider Active NPI

Rachel Meador Bennett, PA-C

  • Physician Assistant
  • Jacksonville, NC
National Provider Identifier
1043656291
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04222 Issued in NC
Practice address
57 Office Park Dr
Jacksonville, NC 28546-7327
Phone
(910) 353-4414
Fax
(910) 353-2972
NPI assigned
May 15, 2013
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04222 NC Primary

Addresses

Primary practice location

57 Office Park Dr
Jacksonville, NC 28546-7327

Mailing address

2111 Neuse Blvd Ste J
New Bern, NC 28560-4318
Phone (252) 636-0300

Other identifiers 1

IdentifierTypeStateIssuer
0010-04222OtherNCNC LICENSE

Other names 1

  • Mrs. Rachel Meador Former name

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
I20130710000093 NC Practitioner - Physician Assistant 7315187689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

2111 Neuse Blvd
Suite J
New Bern, NC 28560-4318
Phone (252) 636-0300

2430 Emerald PL
Suite 103
Greenville, NC 27834-5743
Phone (252) 752-2140

57 Office Park Dr
Jacksonville, NC 28546-7327
Phone (910) 353-6008

PO Box
Suite 645304
Cincinnati, OH 45264-5304

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-04222NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Coast Pain Management Center, PLLC CurrentSince Jun 26, 2020 Accepting new patients

Locations

57 Office Park Dr
Jacksonville, NC 28546
Phone (910) 353-6008

2111 Neuse Blvd
Ste J
New Bern, NC 28560
Phone (252) 636-0300

Organizations & group practices 3

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": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1043656291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 NEUSE BLVD STE J",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285604318",
            "telephone_number": "252-636-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 OFFICE PARK DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467327",
            "telephone_number": "910-353-4414",
            "fax_number": "910-353-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "RACHEL",
        "middle_name": "MEADOR",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-15",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LICENSE",
            "identifier": "0010-04222",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "MEADOR",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.