Individual provider Active NPI

Colleen Patricia Mahar, PA

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1063477107
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103466 Issued in NC
Practice address
2105 Braxton LN Ste 101
Greensboro, NC 27408-2862
Phone
(336) 333-6306
Fax
(336) 333-6309
NPI assigned
Apr 20, 2006
Last updated
May 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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 103466 NC Primary

Addresses

Primary practice location

2105 Braxton LN Ste 101
Greensboro, NC 27408-2862

Mailing address

PO Box 604345
Charlotte, NC 28260-4345

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address colleen.mahar.p1@direct.sss.nextgenshare.com

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
I20070926000200 NC Practitioner - Physician Assistant 6507950268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

13460 Plaza Rd Ext
Suite 100
Charlotte, NC 28215-8923
Phone (980) 488-9450

2105 Braxton LN
Suite 101
Greensboro, NC 27408-2862
Phone (336) 333-6306

501 Hickory Branch Rd
Greensboro, NC 27409-9601
Phone (336) 355-0667

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103466NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Piedmont North Carolina Medical Group, LLC CurrentSince May 1, 2025 Accepting new patients
Watauga Orthopaedics PLC Physician Assistant Past Accepting new patients

Locations

2105 Braxton Ln
Ste 101
Greensboro, NC 27408
Phone (336) 333-6306

501 Hickory Branch Rd
Greensboro, NC 27409
Phone (336) 878-2260

Interoperability endpoints

  • Direct secure messaging: cmahar1681523@direct.novanthealth.org
  • Direct secure messaging: cmahar2791911@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: colleen.mahar.p1@direct.sss.nextgenshare.com

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1063477107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604345",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 BRAXTON LN STE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274082862",
            "telephone_number": "336-333-6306",
            "fax_number": "336-333-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAR",
        "first_name": "COLLEEN",
        "middle_name": "PATRICIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "colleen.mahar.p1@direct.sss.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2105 Braxton Ln",
            "address_2": "Suite 101",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274082861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.