Active NPI
David McCoy Ginn, PA-C
- Physician Assistant
- Greenville, NC
National Provider Identifier
1104148386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-06922
- Practice address
- 1401 N Memorial Dr
Greenville, NC 27834-1278 - Phone
- (252) 378-5862
- NPI assigned
- Feb 16, 2010
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-06922 | NC | Primary |
| Physician Assistant | 363A00000X | 006429 | GA | |
| Physician Assistant | 363A00000X | PA1644 | NV |
Addresses
Primary practice location
1401 N Memorial Dr
Greenville, NC 27834-1278
Mailing address
1401 N Memorial Dr
Greenville, NC 27834-1278
Phone (252) 378-5862
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006429 | GA | MD | Physician Assistant |
| 0010-06922 | NC | MD | Physician Assistant |
| PA1644 | NV | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients |
Locations
1120 15th St
#6000
Augusta, GA 30912
Phone (706) 721-3813
1120 15th St
Bldg O107
Augusta, GA 30912
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Augusta, GA
- NPI 1982089777
-
- Emergency Medicine Physician
- Augusta, GA
- NPI 1053170605
-
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Surgery Physician
- Marietta, GA
- NPI 1124451190
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483056000000",
"number": "1104148386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 N MEMORIAL DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278341278",
"telephone_number": "252-378-5862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 N MEMORIAL DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278341278",
"telephone_number": "252-378-5862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GINN",
"first_name": "DAVID",
"middle_name": "MCCOY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-16",
"last_updated": "2016-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-06922",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "006429",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA1644",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.