Donna M Ajo, PA
Individual provider Active NPI Physician Assistant · Raeford, NC
NPI 1174629414 · NPPES record last updated May 9, 2025
Key facts
- NPI
- 1174629414
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0010-00988 (NC)
- Practice address
- 300 Medical Pavilion Dr Ste 150
Raeford, NC 28376-0030 - Phone
- (910) 904-8025
- Fax
- (910) 615-9751
- NPI assigned
- Sep 15, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170627000850 | NC | Practitioner - Physician Assistant | 2769484955 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110002353 | VA | MD | Family Medicine Physician |
Interoperability endpoints
- dajo27575@capefearvalley.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0110002353 | VA | |
| Physician Assistant | 363A00000X | 0010-00988 | NC | Yes |
Addresses
Primary practice location
300 Medical Pavilion Dr Ste 150
Raeford, NC 28376-0030
Mailing address
504 Broad St
Apt a
Emporia, VA 23847-1843
Phone (678) 755-5248
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0110002353 | Other | VA | LICINCE |
Other providers in Raeford, NC
- Advantage Medsolutions LLC
- Aegis Group Practice LLC
- Alexis Danielle Agers
- Ajels
- Ajels
- Caralynn Albin
- Lashaniece Mahogany Alford
- Alida S Mason LPC LCSW PLLC
- Charles Allen
- Kellie A. Allen
All providers in Raeford, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.