NPIMap

Individual provider Active NPI

Heather Lyn Skinner, PA-C

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1518430974
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08786 Issued in NC
Practice address
5085 Morganton Rd Ste 100
Fayetteville, NC 28314-1497
Phone
(910) 323-3890
Fax
(910) 323-4509
NPI assigned
Jan 9, 2019
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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 0010-08786 NC Primary

Addresses

Primary practice location

5085 Morganton Rd Ste 100
Fayetteville, NC 28314-1497

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

Other identifiers 1

IdentifierTypeStateIssuer
1518430974MedicaidNC

Other names 1

  • Heather Lyn Anderson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190313000091 NC Practitioner - Physician Assistant 5294075131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cape Fear Physical Medicine andGroup PAC ID 2062455231, 3 clinicians
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

1540 Purdue Dr
Fayetteville, NC 28303-5510
Phone (910) 630-1112

1841 Quiet Cove Place
Fayetteville, NC 28304-3857
Phone (910) 630-1112

2303 Wellington Dr SW
Suite B
Wilson, NC 27893-8620
Phone (252) 243-6818

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthsouth Men's Clinic Past Accepting new patients

Organizations & group practices 2

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1518430974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5085 MORGANTON RD STE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141497",
            "telephone_number": "910-323-3890",
            "fax_number": "910-323-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "HEATHER",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518430974",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "ANDERSON",
            "middle_name": "LYN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.