Individual provider Active NPI

Faith Farris, PA

  • Physician Assistant
  • Shallotte, NC
National Provider Identifier
1124865100
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5272 Ocean Hwy W
Shallotte, NC 28470-4006
Phone
(910) 251-9944
Fax
(910) 763-4666
NPI assigned
Jul 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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 Primary

Addresses

Primary practice location

5272 Ocean Hwy W
Shallotte, NC 28470-4006

Mailing address

PO Box 23329
New York, NY 10087-3329

Other practice location 1

1099 Medical Center Dr Ste 100A
Wilmington, NC 28401-7367
Phone (910) 251-9944

Other practice location 2

1099 Medical Center Dr
Wilmington, NC 28401-7346
Phone (910) 251-9944

Other practice location 3

308 S Bennett St
Burgaw, NC 28425-5048
Phone (910) 251-9944

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
I20241231002280 NC Practitioner - Physician Assistant 9638606791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Dermatology PAGroup PAC ID 7012971609, 52 clinicians

Practice addresses (Care Compare)

1099 Medical Ctr Dr
Unit 200300
Wilmington, NC 28401-7346
Phone (910) 251-9944

308 S Bennett St
Burgaw, NC 28425-5048
Phone (910) 251-9944

4201 Lake Boone TRL
Suite 200
Raleigh, NC 27607-7511
Phone (919) 782-2152

5272 Ocean Hwy W
Shallotte, NC 28470-4006
Phone (910) 251-9944

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anne Arundel Dermatology Affiliates PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ffarris@aadermaffiliates.emadirect.md

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": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1124865100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23329",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5272 OCEAN HWY W",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704006",
            "telephone_number": "910-251-9944",
            "fax_number": "910-763-4666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1099 Medical Center Dr Ste 100A",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017367",
            "country_code": "US",
            "telephone_number": "910-251-9944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1099 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017346",
            "country_code": "US",
            "telephone_number": "910-251-9944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "308 S Bennett St",
            "address_purpose": "LOCATION",
            "city": "Burgaw",
            "state": "NC",
            "postal_code": "284255048",
            "country_code": "US",
            "telephone_number": "910-251-9944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "FAITH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

Verify at the official NPI Registry.