NPIMap

Individual provider Active NPI

Robert Nelson, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1255967824
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001009885 Issued in NC
Practice address
2421 Silver Stream LN
Wilmington, NC 28401-7684
Phone
(910) 341-3383
Fax
(910) 815-2961
NPI assigned
Mar 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001009885 NC Primary
Surgical Physician Assistant 363AS0400X

Addresses

Primary practice location

2421 Silver Stream LN
Wilmington, NC 28401-7684

Mailing address

1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 617-6705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200701000395 NC Practitioner - Physician Assistant 2769805217 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

1000 Brabham LN
Jacksonville, NC 28546-5003
Phone (910) 341-1540

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

1222 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

1300 Bridge Barrier Rd
Suite 2
Carolina Beach, NC 28428-3939
Phone (910) 341-1540

5211 S College Rd
Wilmington, NC 28412-2209
Phone (910) 341-1540

8108 B Market St
Wilmington, NC 28411-9386
Phone (910) 341-1540

8114 Market St
Suite 200
Wilmington, NC 28411-9386
Phone (910) 341-1540

9101 Ocean Hwy E
Leland, NC 28451-7867
Phone (910) 341-1540

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001009885NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington Health PLLC CurrentSince Feb 14, 2023 Accepting new patients
Wilmington ASC LLC CurrentSince Feb 14, 2023 Accepting new patients
Atlantic Brain and Spine, P.a. Past Accepting new patients

Locations

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

2421 Silver Stream Ln
Wilmington, NC 28401
Phone (910) 763-2072

Interoperability endpoints

  • Direct secure messaging: rnelson@pcns.ssdirect.aprima.com
  • Direct secure messaging: robert.nelson.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations & group practices 3

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

Hospital & facility affiliations 11

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": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1255967824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-617-6705",
            "fax_number": "910-431-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 SILVER STREAM LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017684",
            "telephone_number": "910-341-3383",
            "fax_number": "910-815-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-16",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001009885",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.