Individual provider Active NPI

Nicholas R Stanwick, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1467634204
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07933 Issued in NC
Practice address
3787 Shipyard Blvd
Wilmington, NC 28403
Phone
(910) 332-3800
Fax
(910) 251-0421
NPI assigned
Dec 4, 2007
Last updated
May 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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 0010-07933 NC Primary
Medical Physician Assistant 363AM0700X 50.002713 OH

Addresses

Primary practice location

3787 Shipyard Blvd
Wilmington, NC 28403

Mailing address

2716 Ashton Dr
Wilmington, NC 28412-2489
Phone (910) 332-3800

Other practice location 1

568 S Cleveland Ave
Suite B
Westerville, OH 43081-8959
Phone (614) 895-3344

Other identifiers 1

IdentifierTypeStateIssuer
0095767MedicaidOH

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
I20180403001895 NC Practitioner - Physician Assistant 7517040033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

2716 Ashton Dr
Wilmington, NC 28412-2489
Phone (910) 332-3800

3787 Shipyard Blvd
Wilmington, NC 28403-6148
Phone (910) 332-3800

5160 Ocean Hwy W
Shallotte, NC 28470-4012
Phone (910) 332-3800

799 Doctors CT
Roxboro, NC 27573-4571
Phone (336) 599-4079

8115 Market St
Suite 108
Wilmington, NC 28411-8429
Phone (910) 332-3800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as individual
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.002713OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Physician Assistant CurrentSince Apr 23, 2018 Accepting new patients
Emergeortho PA CurrentSince Apr 23, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

2716 Ashton Dr
Wilmington, NC 28412
Phone (910) 332-1534

3787 Shipyard Blvd
Wilmington, NC 28403
Phone (910) 341-2444

Interoperability endpoints

  • Direct secure messaging: nicholas.stanwick.1@847.direct.athenahealth.com
  • Direct secure messaging: nstanwick1252023@direct.novanthealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1467634204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2716 ASHTON DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122489",
            "telephone_number": "910-332-3800",
            "fax_number": "910-251-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3787 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28403",
            "telephone_number": "910-332-3800",
            "fax_number": "910-251-0421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "568 S Cleveland Ave",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430818959",
            "country_code": "US",
            "telephone_number": "614-895-3344",
            "fax_number": "614-895-3795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANWICK",
        "first_name": "NICHOLAS",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07933",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.002713",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0095767",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.