Individual provider Active NPI

Meredith Deily, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1174196919
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11457 Issued in NC
Practice address
1717 Shipyard Blvd Ste 200
Wilmington, NC 28403-8019
Phone
(910) 769-2583
NPI assigned
Jul 20, 2021
Last updated
Jul 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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 0010-11457 NC Primary

Addresses

Primary practice location

1717 Shipyard Blvd Ste 200
Wilmington, NC 28403-8019

Mailing address

1717 Shipyard Blvd Ste 200
Wilmington, NC 28403-8019
Phone (910) 769-2583

Other practice location 1

461 Western Blvd Ste 122
Jacksonville, NC 28546-7637
Phone (910) 333-0283

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
I20210728002221 NC Practitioner - Physician Assistant 0446653414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tinsley Surgical PAGroup PAC ID 2769728526, 6 clinicians

Practice addresses (Care Compare)

1717 Shipyard Blvd
Suite 200
Wilmington, NC 28403-8019
Phone (910) 769-2583

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-11457NCMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: mdeily1469379@direct.novanthealth.org
  • Direct secure messaging: meredith.deily.1@22201.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1174196919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 SHIPYARD BLVD STE 200",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038019",
            "telephone_number": "910-769-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SHIPYARD BLVD STE 200",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038019",
            "telephone_number": "910-769-2583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "461 Western Blvd Ste 122",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285467637",
            "country_code": "US",
            "telephone_number": "910-333-0283",
            "fax_number": "910-333-0513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEILY",
        "first_name": "MEREDITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.