Misty Lynn Rouse, PA-C
Individual provider Active NPI Physician Assistant · Mount Olive, NC
NPI 1184880130 · NPPES record last updated Mar 27, 2023
Key facts
- NPI
- 1184880130
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 001001458 (NC)
- Practice address
- 201 N Breazeale Ave
Mount Olive, NC 28365-1603 - Phone
- (919) 658-4954
- NPI assigned
- Jul 30, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.23 of 100
- Quality
- 70.25
- Improvement activities
- 40
- Cost
- 77.1
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 |
|---|---|---|---|---|
| I20081008000388 | NC | Practitioner - Physician Assistant | 9133183718 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001001458 | NC | MD | Physician Assistant |
Interoperability endpoints
- mistyrouse@mtolivefamily.ssdirect.aprima.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001001458 | NC | Yes |
Addresses
Primary practice location
201 N Breazeale Ave
Mount Olive, NC 28365-1603
Mailing address
201 N Breazeale Ave
Mount Olive, NC 28365-1603
Phone (919) 658-4954
NPI Registry JSON
{
"created_epoch": "1217376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679875200000",
"number": "1184880130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 N BREAZEALE AVE",
"city": "MOUNT OLIVE",
"state": "NC",
"postal_code": "283651603",
"telephone_number": "919-658-4954",
"fax_number": "919-658-5754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 N BREAZEALE AVE",
"city": "MOUNT OLIVE",
"state": "NC",
"postal_code": "283651603",
"telephone_number": "919-658-4954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUSE",
"first_name": "MISTY",
"middle_name": "LYNN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-30",
"last_updated": "2023-03-27",
"certification_date": "2023-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "001001458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Olive, NC
- Larry Price
- Terry Louise Price
- Natalie Rockell Ramirez
- Sonya F Rose
- Roseboro Pharmacy Inc
- Brittney Sanderson
- Victoria Morgan Sanderson
- Garrison Seaman
- Skill Creations, Inc.
- Sovran Senior Living, LLC
All providers in Mount Olive, 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 Mar 27, 2023. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.