Individual provider Active NPI

Richard William Poole, PA-C

  • Medical Physician Assistant
  • Hickory, NC
National Provider Identifier
1548462161
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-10300 Issued in NC
Practice address
2280 US Highway 70 SE
Hickory, NC 28602-5164
Phone
(828) 270-7331
Fax
(828) 322-3280
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-10300 NC Primary

Addresses

Primary practice location

2280 US Highway 70 SE
Hickory, NC 28602-5164

Mailing address

118 Gaymont Cir
Statesville, NC 28625-8320
Phone (704) 873-1855

Other names 1

  • Rick Poole Other name

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
I20200812001868 NC Practitioner - Physician Assistant 8123444841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

7010 NC Hwy 751
Durham, NC 27707-5733
Phone (919) 313-3900

Merit-based Incentive Payment System (MIPS)

Final score
74.09 of 100Reported as group
Quality
65.78
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-10300NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fastmed Primary Care, P.C. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1548462161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 GAYMONT CIR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258320",
            "telephone_number": "704-873-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 US HIGHWAY 70 SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286025164",
            "telephone_number": "828-270-7331",
            "fax_number": "828-322-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "RICHARD",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-10300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICK",
            "last_name": "POOLE",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.