Angela B Ford, PA-C

Individual provider Active NPI Physician Assistant · Oak Ridge, NC

NPI 1134479645 · NPPES record last updated Apr 26, 2014

Key facts

NPI
1134479645
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
102891 (NC)
Practice address
7901 McCreedy Dr
Oak Ridge, NC 27310-9695
Phone
(336) 558-3245
NPI assigned
Sep 12, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20130717000219 NC Practitioner - Physician Assistant 5890935720 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 102891 NC Yes

Addresses

Primary practice location

7901 McCreedy Dr
Oak Ridge, NC 27310-9695

Mailing address

7901 McCreedy Dr
Oak Ridge, NC 27310-9695
Phone (336) 558-3245

Other names

  • Ms. Angela B Wade Former name

Other providers in Oak Ridge, NC

All providers in Oak Ridge, NC · Physician Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.