Individual provider Active NPI

David Wayne Patterson, MPA, PA-C

  • Physician Assistant
  • Wilson, NC
National Provider Identifier
1073553525
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA002708L Issued in PA
Practice address
2874 Ward Blvd
Wilson, NC 27893-1761
Phone
(252) 291-5600
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA002708L PA Primary
Medical Physician Assistant 363AM0700X MA002708L PA

Addresses

Primary practice location

2874 Ward Blvd
Wilson, NC 27893-1761

Mailing address

2874 Ward Blvd
Wilson, NC 27893-1761
Phone (252) 291-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230424002196 ND Practitioner - Physician Assistant 6608049523 Reassigns benefits to 1 organization
I20240731004290 NC Practitioner - Physician Assistant 6608049523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern Illinois University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Surgery Center PAGroup PAC ID 3173599479, 72 clinicians

Practice addresses (Care Compare)

1450 Professional Park Dr
Winston Salem, NC 27103-1300
Phone (336) 724-2434

532 W Park Cir
North Wilkesboro, NC 28659-3547
Phone (336) 667-6600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as group
Promoting interoperability
89
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA002708LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Surgery Center PA CurrentSince Sep 1, 2024 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

532 W Park Cir
North Wilkesboro, NC 28659
Phone (336) 667-6600

2874 Ward Blvd
Wilson, NC 27893
Phone (252) 291-5600

1450 Professional Park Dr
Winston Salem, NC 27103
Phone (336) 724-2434

1450 Professional Park Dr
Ste 150
Winston Salem, NC 27103
Phone (336) 724-2434

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1073553525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2874 WARD BLVD",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278931761",
            "telephone_number": "252-291-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2874 WARD BLVD",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278931761",
            "telephone_number": "252-291-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "MPA, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002708L",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA002708L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

Verify at the official NPI Registry.