Individual provider Active NPI

Alexandra Jane Talbert, PA-C

  • Physician Assistant
  • Clemmons, NC
National Provider Identifier
1164152245
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001012332 Issued in NC
Practice address
5175 Old Clemmons School Rd
Clemmons, NC 27012-9087
Phone
(336) 718-3960
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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 001012332 NC Primary

Addresses

Primary practice location

5175 Old Clemmons School Rd
Clemmons, NC 27012-9087

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other names 1

  • Alexandra Moyer Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address atalbert776495@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
I20230705001401 NC Practitioner - Physician Assistant 8224410543 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001012332NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince May 22, 2023 Accepting new patients
Novant Medical Group, Inc. CurrentSince May 22, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

5175 Old Clemmons School Rd
Clemmons, NC 27012
Phone (336) 718-3960

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

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1164152245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5175 OLD CLEMMONS SCHOOL RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129087",
            "telephone_number": "336-718-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALBERT",
        "first_name": "ALEXANDRA",
        "middle_name": "JANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001012332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "atalbert776495@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "5175 Old Clemmons School Rd",
            "city": "Clemmons",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270129087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "MOYER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.