Individual provider Active NPI

Frank C Patrick, PA

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1336102060
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101216 Issued in NC
Practice address
105 Hanes Square Cir
Winston Salem, NC 27103-5514
Phone
(336) 441-5569
Fax
(336) 771-1907
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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 011820 NY
Physician Assistant 363A00000X 101216 NC Primary

Addresses

Primary practice location

105 Hanes Square Cir
Winston Salem, NC 27103-5514

Mailing address

PO Box 601843
Charlotte, NC 28260-1843

Other practice location 1

226 Academy St S
Ahoskie, NC 27910-2451
Phone (252) 209-3994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071110000136 NY Practitioner - Physician Assistant 5597853424 Reassigns benefits to 1 organization
I20161222001568 NC Practitioner - Physician Assistant 5597853424 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

105 Hanes Square Cir
Winston Salem, NC 27103-5514
Phone (336) 441-5569

2452 Fairlawn CT
Winston Salem, NC 27106-3884
Phone (336) 281-5965

2635 Lawndale Dr
Greensboro, NC 27408-4802
Phone (336) 867-4310

3163 Gammon LN
Clemmons, NC 27012-9052
Phone (336) 310-5571

50 Miller St
Suite C
Winston Salem, NC 27104-4206
Phone (336) 310-5535

5870 Samet Dr
High Point, NC 27265-3646
Phone (336) 803-7311

794 S Main St
Suite B
Kernersville, NC 27284-4074
Phone (336) 904-2317

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101216NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alamance Regional Medical Center, Inc CurrentSince Oct 31, 2016 Accepting new patients
Alamance Regional Medical Center, Inc. CurrentSince Oct 31, 2016 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Nov 15, 2017 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Nov 15, 2017 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation Physician Assistant CurrentSince Oct 31, 2016 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince May 20, 2022 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Oct 31, 2016 Accepting new patients
Carolina Medicorp Enterprises LLC CurrentSince May 20, 2022 Accepting new patients
Carolina Medicorp Enterprises Inc Past Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1123 N Church St
Greensboro, NC 27401
Phone (336) 832-4400

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

105 Hanes Square Cir
Winston Salem, NC 27103
Phone (336) 441-5569

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

130 North St
Walton, NY 13856
Phone (607) 865-6541

Interoperability endpoints

  • Direct secure messaging: fpatrick1057961@direct.novanthealth.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1336102060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HANES SQUARE CIR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035514",
            "telephone_number": "336-441-5569",
            "fax_number": "336-771-1907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "226 Academy St S",
            "address_purpose": "LOCATION",
            "city": "Ahoskie",
            "state": "NC",
            "postal_code": "279102451",
            "country_code": "US",
            "telephone_number": "252-209-3994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "FRANK",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011820",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.