Individual provider Active NPI

Daniel Alan Matthews, PA-C

  • Physician Assistant
  • Locust, NC
National Provider Identifier
1417924465
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103285 Issued in NC
Practice address
236 Market St Ste 110
Locust, NC 28097-9439
Phone
(704) 384-9590
Fax
(704) 384-9591
NPI assigned
Mar 8, 2006
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103285 NC Primary

Addresses

Primary practice location

236 Market St Ste 110
Locust, NC 28097-9439

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1035C 7 Lks N
West End, NC 27376-9753
Phone (910) 673-0045

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
I20100506000979 NC Practitioner - Physician Assistant 5597893818 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Quickcare Family Practice, PLLCGroup PAC ID 0840682340, 107 clinicians

Practice addresses (Care Compare)

2265 NC Hwy 24 27 E
Biscoe, NC 27209-9758
Phone (919) 828-1131

41 Bain St
Lillington, NC 27546-6185
Phone (843) 322-1933

5156 US 29 Business
Reidsville, NC 27320-7998
Phone (910) 828-1131

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103285NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland Memorial Hospital Inc CurrentSince Sep 16, 2023 Accepting new patients
FHPG, LLC Family Medicine Past Accepting new patients
Firsthealth of the Carolinas, Inc Past Accepting new patients
FHPG, LLC Family Medicine Past Accepting new patients

Locations

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

Organizations & group practices 6

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1417924465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 MARKET ST STE 110",
            "city": "LOCUST",
            "state": "NC",
            "postal_code": "280979439",
            "telephone_number": "704-384-9590",
            "fax_number": "704-384-9591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1035C 7 Lks N",
            "address_purpose": "LOCATION",
            "city": "West End",
            "state": "NC",
            "postal_code": "273769753",
            "country_code": "US",
            "telephone_number": "910-673-0045",
            "fax_number": "910-673-1156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "DANIEL",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust, NC

Sources for this page

Verify at the official NPI Registry.