Individual provider Active NPI

Carrie Ann Fales, MD

  • Emergency Medicine Physician
  • Wilmington, NC
National Provider Identifier
1417273624
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
164587 Issued in NC
Practice address
4402 Shipyard Blvd
Wilmington, NC 28403-6161
Phone
(910) 202-3363
NPI assigned
Apr 13, 2010
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 164587 NC Primary

Addresses

Primary practice location

4402 Shipyard Blvd
Wilmington, NC 28403-6161

Mailing address

4402 Shipyard Blvd
Wilmington, NC 28403-6161
Phone (910) 202-3363

Other identifiers 2

IdentifierTypeStateIssuer
1417273624MedicaidNC
1417273624OtherNCCHAMPUS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130814000759 NC Practitioner - Emergency Medicine 4587806971 Reassigns benefits to 12 organizations
I20260507000021 NY Practitioner - Emergency Medicine 4587806971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Human Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 667-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital Inc CurrentSince May 1, 2019 Accepting new patients
Novant Health Thomasville Medical Center, LLC CurrentSince May 1, 2019 Accepting new patients
Tanglewood Park Physicians, PLLC Emergency Medicine CurrentSince Apr 1, 2019 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Ecep II PA Emergency Medicine Current Accepting new patients
J. Arthur Dosher Memorial Hospital CurrentSince Sep 13, 2024 Accepting new patients
Piedmont Triad Physicians, PLLC Emergency Medicine CurrentSince Mar 1, 2019 Accepting new patients
J. Arthur Dosher Memorial Hospital CurrentSince Sep 13, 2024 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Nov 1, 2015 Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince Feb 4, 2024 Accepting new patients
Brunswick Physician Partners, PLLC Emergency Medicine CurrentSince Feb 1, 2019 Accepting new patients
J. Arthur Dosher Memorial Hospital Current Accepting new patients
NMG Health Services LLC CurrentSince Feb 4, 2024 Accepting new patients
Ecep II PA Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince May 1, 2019 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Brunswick Community Hospital, LLC CurrentSince May 1, 2019 Accepting new patients
Kernersville Emergency Group, PLLC Emergency Medicine CurrentSince Apr 1, 2019 Accepting new patients
Ecep II PA Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince May 1, 2019 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Pender Memorial Hospital, Incorporated Past Accepting new patients
Brunswick Community Hospital, LLC PastSince Oct 13, 2024 Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

507 E Fremont St
Burgaw, NC 28425
Phone (910) 259-5451

6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

821 N Atlantic Ave
Southport, NC 28461
Phone (910) 457-3827

924 N Howe St
Southport, NC 28461
Phone (910) 457-3800

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

151 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 662-8440

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

4402 Shipyard Blvd
Wilmington, NC 28403
Phone (910) 202-3363

5301 Wrightsville Ave
Wilmington, NC 28403
Phone (910) 452-8100

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Interoperability endpoints

  • Direct secure messaging: cfales696424@direct.novanthealth.org
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 24

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 24

Hospital & facility affiliations 4

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": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1417273624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036161",
            "telephone_number": "910-202-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036161",
            "telephone_number": "910-202-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALES",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "164587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417273624",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "1417273624",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.