Active NPI
Nolan Crain, PA
- Physician Assistant
- Wilmington, NC
National Provider Identifier
1063840577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-06589
- Practice address
- 510 Carolina Bay Dr
Ste 110
Wilmington, NC 28403-2041 - Phone
- (910) 662-6000
- NPI assigned
- Oct 18, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-06589 | NC | Primary |
Addresses
Primary practice location
510 Carolina Bay Dr
Ste 110
Wilmington, NC 28403-2041
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
7910 US Hwy 117 S
Unit 120
Rocky Point, NC 28457-9431
Phone (910) 300-4500
Other practice location 2
7420 Market St
Wilmington, NC 28411-9453
Phone (910) 686-2525
Other practice location 3
5145 S College Rd
Wilmington, NC 28412-2207
Phone (910) 792-1144
Other practice location 4
1960 S 16th St
Wilmington, NC 28401-6676
Phone (910) 343-9991
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-06589 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1382054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591920000000",
"number": "1063840577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19305",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282199305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 CAROLINA BAY DR",
"address_2": "STE 110",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284032041",
"telephone_number": "910-662-6000"
}
],
"practiceLocations": [
{
"address_1": "7910 US Hwy 117 S",
"address_2": "Unit 120",
"address_purpose": "LOCATION",
"city": "Rocky Point",
"state": "NC",
"postal_code": "284579431",
"country_code": "US",
"telephone_number": "910-300-4500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7420 Market St",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284119453",
"country_code": "US",
"telephone_number": "910-686-2525",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5145 S College Rd",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284122207",
"country_code": "US",
"telephone_number": "910-792-1144",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1960 S 16th St",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284016676",
"country_code": "US",
"telephone_number": "910-343-9991",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CRAIN",
"first_name": "NOLAN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-18",
"last_updated": "2020-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-06589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.