Miranda Jean Weavil, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12687 Issued in NC

Practice address

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Phone

(336) 718-5570

Fax

(336) 718-5569

NPI assigned

Oct 31, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Thomasville Medical Center LLCGroup PAC ID 5890605224, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Thomasville Medical Center Hospital, Thomasville, NC, CCN 340085
• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mweavil541927@direct.novanthealth.org

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.

• Novant Health Thomasville Medical Center, LLC

  • Specialist
  • Thomasville, NC
  • NPI 1033160205
  Medicare reassignment Care Compare group
• Novant Health Thomasville Medical Center LLC

  • Hematology & Oncology Physician
  • Winston Salem, NC
  • NPI 1649159609
  NPD
• Novant Health Medical Group Coastal Region, LLC

  • Hematology & Oncology Physician
  • Carolina Shores, NC
  • NPI 1801565684
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Novant Health Thomasville Medical Center, LLC

  • General Acute Care Hospital
  • Thomasville, NC
  • NPI 1801848767
  Care Compare affiliation

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1356058358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 935983",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311935983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-5570",
            "fax_number": "336-718-5569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Bethesda Ct",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033019",
            "country_code": "US",
            "telephone_number": "336-718-5570",
            "fax_number": "336-277-8659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVIL",
        "first_name": "MIRANDA",
        "middle_name": "JEAN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356058358",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trent S Weatherley, MD
• Barbara Sell Weaver, LCMHC
• Kim Price Weaver, PHYSICIAN ASSISTANT
• Lisa Ann Weaver, M.ED, CCC-SLP
• Richard Grey Weaver Jr., MD
• Nicholas Weavil
• Kaleigh Smith Webb
• Lawrence Xavier Webb, MD
• Julie Weber
• Stephen Florian Weber, MD, FACP

• Physician Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.