Individual provider Active NPI

Matthew Paul Norman

  • Physician Assistant
  • Zebulon, NC
National Provider Identifier
1558095414
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-13956 Issued in NC
Practice address
1260 N Arendell Ave
Zebulon, NC 27597-8730
Phone
(919) 235-1965
NPI assigned
Jul 14, 2022
Last updated
Apr 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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 0010-13956 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1260 N Arendell Ave
Zebulon, NC 27597-8730

Mailing address

3709 Coach Lantern Ave
Wake Forest, NC 27587-3404
Phone (919) 610-2360

Other practice location 1

3709 Coach Lantern Ave
Wake Forest, NC 27587-3404
Phone (919) 610-2360

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
I20240429003339 NC Practitioner - Physician Assistant 6709226442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

10000 Falls of Neuse Rd
Raleigh, NC 27614-7838
Phone (919) 350-1300

1260 N Arendell Ave
Zebulon, NC 27597-8730
Phone (919) 235-1965

815 Springfield Commons Dr
Raleigh, NC 27609-8529
Phone (919) 235-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-13956NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Specialty Physicians CurrentSince Mar 11, 2024 Accepting new patients
Wake Specialty Physicians LLC CurrentSince Mar 11, 2024 Accepting new patients
Wake Specialty Physicians, LLC Physician Assistant Past Accepting new patients

Locations

2216 E NC Highway 54
Durham, NC 27713
Phone (919) 544-2020

7021 NC Highway 751
Durham, NC 27707
Phone (919) 235-0365

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

4530 Fayetteville Rd
Raleigh, NC 27603
Phone (919) 235-1930

6800 Glenwood Ave
Raleigh, NC 27612
Phone (919) 235-1939

938 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 235-1525

2001 S Main St
Wake Forest, NC 27587
Phone (919) 562-3155

1260 N Arendell Ave
Zebulon, NC 27597
Phone (919) 235-1326

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 3

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": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1558095414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 COACH LANTERN AVE",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873404",
            "telephone_number": "919-610-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 N ARENDELL AVE",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275978730",
            "telephone_number": "919-235-1965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3709 Coach Lantern Ave",
            "address_purpose": "LOCATION",
            "city": "Wake Forest",
            "state": "NC",
            "postal_code": "275873404",
            "country_code": "US",
            "telephone_number": "919-610-2360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "MATTHEW",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-14",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13956",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zebulon, NC

Sources for this page

Verify at the official NPI Registry.