Individual provider Active NPI

Ravi K. Singh, PA-C

  • Physician Assistant
  • Wake Forest, NC
National Provider Identifier
1083620009
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06925 Issued in NC
Practice address
110 Capcom Ave Ste 201
Wake Forest, NC 27587-6531
Phone
(919) 758-8677
Fax
(919) 758-8723
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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 0010-06925 NC Primary

Addresses

Primary practice location

110 Capcom Ave Ste 201
Wake Forest, NC 27587-6531

Mailing address

PO Box 1430
Harrisonburg, VA 22803-1430
Phone (540) 689-5700

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
I20170420002628 NC Practitioner - Physician Assistant 3678558350

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001790CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Carolina Urology Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1083620009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1430",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228031430",
            "telephone_number": "540-689-5700",
            "fax_number": "844-721-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CAPCOM AVE STE 201",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876531",
            "telephone_number": "919-758-8677",
            "fax_number": "919-758-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINGH",
        "first_name": "RAVI",
        "middle_name": "K.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

Verify at the official NPI Registry.