Mary E Bundle, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

00103537 Issued in NC

Practice address

107 S Wilmington St
Richlands, NC 28574-8298

Phone

(910) 324-7268

Fax

(910) 324-7273

NPI assigned

Dec 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jacksonville Children'S and Multispecialty Clinic, PAGroup PAC ID 6709968811, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Well Care Home Health Home health agency, Wilmington, NC, CCN 347002
• Centerwell Home Health Home health agency, Pollocksville, NC, CCN 347333
• Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Jacksonville Children'S and Multispecialty Clinic, PA

  • Family Medicine Physician
  • Jacksonville, NC
  • NPI 1164519070

  NC

  Medicare reassignment Care Compare group
• Amm Healthcare, PA

  • Family Medicine Physician
  • Cary, NC
  • NPI 1528639689
  NPD
• Family Care Clinic, P.a.

  • Clinic/Center
  • Jacksonville, NC
  • NPI 1316033590
  NPD (past)

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

• Onslow Memorial Hospital Inc

  • General Acute Care Hospital
  • Jacksonville, NC
  • NPI 1679535496

  Hospital

  Care Compare affiliation
• Tar Heel Health Care Services, LLC

  • Home Health Agency
  • Pollocksville, NC
  • NPI 1043243835
  Care Compare affiliation
• Well Care Home Health, Inc

  • Home Health Agency
  • Wilmington, NC
  • NPI 1760470660
  Care Compare affiliation

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1073598686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986513",
            "address_2": "DEPARTMENT 100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986513",
            "telephone_number": "910-219-8326",
            "fax_number": "910-939-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S WILMINGTON ST",
            "city": "RICHLANDS",
            "state": "NC",
            "postal_code": "285748298",
            "telephone_number": "910-324-7268",
            "fax_number": "910-324-7273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466328",
            "country_code": "US",
            "telephone_number": "910-353-0581",
            "fax_number": "910-353-1536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNDLE",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "00103537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridging Legacies
• Jennifer Gwynn Brock, MSW, LCSW
• Amylee Brooks, PA-C
• BSD Chiro
• BSD Chiropractic Richlands PLLC
• Melanie Burns
• Sheree Rose Castro
• Taylor Lynn Chaffins, OTR/L
• Charles Nicholas Chesnutt Jr.
• Candie Cintron, ASSOCIATES

• Physician Assistant in Richlands, NC
• Providers in Richlands, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.