Lori Hartley, PA
Individual provider Active NPI Physician Assistant · Wallace, NC
NPI 1285849950 · NPPES record last updated Nov 1, 2010
Key facts
- NPI
- 1285849950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 103475 (NC)
- Practice address
- 120 Medical Village Dr
Wallace, NC 28466-1660 - Phone
- (910) 285-2330
- NPI assigned
- May 14, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2001
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Moore Medical Group Inc
SNF Physiatry Services NC PLLC
Practice addresses (Care Compare)
2050 Mercantile Dr
Leland, NC 28451-4053
Phone (910) 371-2500
2207 Delaney Ave
Wilmington, NC 28403-6010
Phone (910) 763-3481
3200 Waterfield Dr
Garner, NC 27529-7727
Phone (919) 800-4000
414 Fayetteville St
FL 4
Raleigh, NC 27601-1793
Phone (877) 544-4446
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 |
|---|---|---|---|---|
| I20110218000717 | NC | Practitioner - Physician Assistant | 5799966073 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Rehabilitation Associates | Past |
Accepting new patients | |
| SNF Physiatry Services NC PLLC | Past | Accepting new patients | |
| SNF Physiatry Services PA PLLC | Past | Accepting new patients | |
| Goshen Medical Center Incorporated | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 103475 | NC | Yes |
Addresses
Primary practice location
120 Medical Village Dr
Wallace, NC 28466-1660
Mailing address
2004 Muirfield CT
Wilmington, NC 28403-5500
Phone (910) 399-1400
Other providers in Wallace, NC
- Julie Eileen Gore
- Goshen Medical Center Incorporated
- Graybar Chiropractic, Inc.
- Michael Francis Graybar Jr.
- Ryan Michael Graybar
- Crystal Rose Havens
- Tyler Hawke
- Helping Hands Care Management Services
- Helping Hands Care Management Services, Inc
- Helping Hands Care Management Services, Inc.
All providers in Wallace, 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 Nov 1, 2010. 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.