Individual provider Active NPI

Haleigh Elizabeth Prysock, PA-C

  • Medical Physician Assistant
  • Clayton, NC
National Provider Identifier
1356905228
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-15792 Issued in NC
Practice address
12701 Clayton Blvd
Clayton, NC 27520-2195
Phone
(919) 235-1968
NPI assigned
Apr 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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 0010-15792 NC
Medical Physician Assistant 363AM0700X 0010-15792 NC Primary

Addresses

Primary practice location

12701 Clayton Blvd
Clayton, NC 27520-2195

Mailing address

PO Box 602195
Clayton, NC 28260-2195
Phone (919) 350-0351

Other identifiers 1

IdentifierTypeStateIssuer
1356905228MedicaidNC

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251105001285 NC Practitioner - Physician Assistant 2668962093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

10000 Falls of Neuse Rd
Raleigh, NC 27614-7838
Phone (919) 350-1300

126 Pritchard Rd
Clayton, NC 27527-9297
Phone (919) 235-1036

12701 US 70 Business Hwy W
Clayton, NC 27520-2195
Phone (919) 350-0554

6800 Glenwood Ave
Raleigh, NC 27612-7133
Phone (919) 235-1939

815 Springfield Commons Dr
Raleigh, NC 27609-8529
Phone (919) 235-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-15792NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Specialty Physicians LLC CurrentSince Nov 16, 2025 Accepting new patients
Autism Society of North Carolina, Inc. Past Accepting new patients
Wake Specialty Physicians LLC PastSince Jul 13, 2025 Accepting new patients
Wake Specialty Physicians LLC PastSince Nov 8, 2025 Accepting new patients
Wake Specialty Physicians, LLC Physician Assistant PastSince Jul 13, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hprysock403808@directhisp.wakemed.org

Organizations & group practices 5

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 2

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": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1356905228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 CLAYTON BLVD",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202195",
            "telephone_number": "919-235-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYSOCK",
        "first_name": "HALEIGH",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-26",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15792",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-15792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356905228",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.