NPIMap

Individual provider Active NPI

Craig Sumner Purcell, P.A.-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1306960216
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102990 Issued in NC
Practice address
601 E Rollins St Ste 400
Orlando, FL 32803-1248
Phone
(407) 303-5600
NPI assigned
Mar 17, 2007
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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 102990 NC Primary

Addresses

Primary practice location

601 E Rollins St Ste 400
Orlando, FL 32803-1248

Mailing address

630 South Bennett Street
Suite 100
Southern Pines, NC 28387
Phone (910) 692-4821

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cpurcell213910@direct.unc.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC, FL, GA, VA, TN6 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20120910000544 NC Practitioner - Physician Assistant 7517115934 Reassigns benefits to 6 organizations
I20220816000579 SC Practitioner - Physician Assistant 7517115934 Reassigns benefits to 1 organization
I20220909002655 FL Practitioner - Physician Assistant 7517115934 Reassigns benefits to 5 organizations
I20221020000435 GA Practitioner - Physician Assistant 7517115934 Reassigns benefits to 5 organizations
I20221028000071 VA Practitioner - Physician Assistant 7517115934 Reassigns benefits to 3 organizations
I20240212000615 TN Practitioner - Physician Assistant 7517115934 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102990NCMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
CDT Healthcare Physician Assistant CurrentSince Jul 31, 2020 Accepting new patients
United Emergency Services, Inc. Physician Assistant Past Accepting new patients

Locations

101 Walmart Supercenter
Siler City, NC 27344
Phone (919) 663-3911

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1306960216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 SOUTH BENNETT STREET",
            "address_2": "SUITE 100",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "28387",
            "telephone_number": "910-692-4821",
            "fax_number": "910-692-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST STE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-303-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "CRAIG",
        "middle_name": "SUMNER",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-17",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpurcell213910@direct.unc.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2500 Blue Ridge Rd Ste 417",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.