Individual provider Active NPI

David W Zeyfang, PA-C

  • Medical Physician Assistant
  • Greensboro, NC
National Provider Identifier
1124067707
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
100919 Issued in NC
Practice address
309 New St
Greensboro, NC 27405-3654
Phone
(339) 379-9708
Fax
(336) 553-2085
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 100919 NC Primary

Addresses

Primary practice location

309 New St
Greensboro, NC 27405-3654

Mailing address

309 New St
Greensboro, NC 27405-3654
Phone (339) 379-9708

Other identifiers 2

IdentifierTypeStateIssuer
561274347OtherNCCKA'S TAX ID#
8102885MedicaidNC

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
I20091223000505 NC Practitioner - Physician Assistant 2567502578 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Kidney Associates CurrentSince Jul 26, 2001 Accepting new patients

Locations

309 New St
Greensboro, NC 27405
Phone (336) 379-9708

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10065404
  • Direct secure messaging: davidzeyfang@cka.allscriptsdirect.net

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1124067707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 NEW ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053654",
            "telephone_number": "339-379-9708",
            "fax_number": "336-553-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 NEW ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053654",
            "telephone_number": "339-379-9708",
            "fax_number": "336-553-2085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEYFANG",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "100919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CKA'S TAX ID#",
            "identifier": "561274347",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8102885",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.