Individual provider Active NPI

Rory McEathron, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1144713009
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08205 Issued in NC
Practice address
105 Vest Mill Cir
Winston Salem, NC 27103-2943
Phone
(336) 718-7800
NPI assigned
Jun 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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 0010-08205 NC Primary

Addresses

Primary practice location

105 Vest Mill Cir
Winston Salem, NC 27103-2943

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmceathron653644@direct.novanthealth.org

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
I20190401002380 NC Practitioner - Physician Assistant 8820339880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

105 Vest Mill Cir
Winston Salem, NC 27103-2943
Phone (336) 718-7800

291 Broad St
Kernersville, NC 27284-2932
Phone (336) 993-8181

6301 Stadium Dr
Clemmons, NC 27012-8766
Phone (336) 766-6473

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. CurrentSince Aug 6, 2018 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 12, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 12, 2023 Accepting new patients
Forsyth Memorial Hospital, Inc CurrentSince Aug 6, 2018 Accepting new patients
Forsyth Memorial Hospital, Inc Past Accepting new patients

Locations

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

105 Vest Mill Cir
Winston Salem, NC 27103
Phone (336) 718-7800

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1144713009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VEST MILL CIR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032943",
            "telephone_number": "336-718-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEATHRON",
        "first_name": "RORY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-14",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmceathron653644@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "105 Vest Mill Cir",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271032943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.