Individual provider Active NPI

Madison Fermo, PA-C

  • Physician Assistant
  • Salisbury, NC
National Provider Identifier
1225767718
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12135 Issued in NC
Practice address
612 Mocksville Ave
Salisbury, NC 28144-2732
Phone
(704) 210-5000
NPI assigned
Jun 9, 2022
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 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 0010-12135 NC Primary

Addresses

Primary practice location

612 Mocksville Ave
Salisbury, NC 28144-2732

Mailing address

115 E Park Ave Unit 105
Charlotte, NC 28203-3709
Phone (716) 491-6234

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
I20220803002588 NC Practitioner - Physician Assistant 2668854985 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
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1130 Tree of Life LN
Cornelius, NC 28031-9454
Phone (980) 310-6160

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4572

612 Mocksville Ave
Salisbury, NC 28144-2732
Phone (704) 210-5099

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Medical Group, Inc CurrentSince Aug 1, 2022 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2022 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

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

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

Interoperability endpoints

  • Direct secure messaging: mfermo1067486@direct.novanthealth.org

Organizations & group practices 5

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": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1225767718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E PARK AVE UNIT 105",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282033709",
            "telephone_number": "716-491-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 MOCKSVILLE AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442732",
            "telephone_number": "704-210-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERMO",
        "first_name": "MADISON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.