Person Surgical Associates PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PERSON SURGICAL ASSOCIATES PA

Practice address

783 Doctors CT
Roxboro, NC 27573-4575

Phone

(336) 599-2787

Fax

(336) 599-4046

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Mathew George, MDNPI 1629012653

Title

President

Phone

(336) 599-2787

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mathew George, MD

  • Surgery Physician
  • Roxboro, NC
  • NPI 1629012653
  Medicare reassignment NPD Authorized official
• Crystal Lynn Martin, AGNP-BC

  • Nurse Practitioner
  • Roxboro, NC
  • NPI 1871246215

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1376585836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3235",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277153235",
            "telephone_number": "919-544-6318",
            "fax_number": "919-544-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "783 DOCTORS CT",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734575",
            "telephone_number": "336-599-2787",
            "fax_number": "336-599-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSON SURGICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-599-2787",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89014CV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC GROUP NO",
            "identifier": "014CV",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Person Memorial Hospital
• Person Memorial Hospital
• Person Memorial Hospital
• Person Memorial Hospital
• Person Physicians, LLC
• John L Petersen, MD
• Erin Marie Petruso, OTR/L
• Pettiford Homes Dba McDaniel Homes
• Martha Mellette Pickett, CCS
• Benjamin Dent Pierce, PA-C

• Surgery Physician in Roxboro, NC
• Providers in Roxboro, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.