Individual provider Active NPI

Zakary Runyon, PA-C

  • Physician Assistant
  • Elkin, NC
National Provider Identifier
1558127340
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
180 Parkwood Dr
Elkin, NC 28621-2430
Phone
(404) 645-7645
NPI assigned
Feb 28, 2024
Last updated
Mar 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 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 NU Primary

Addresses

Primary practice location

180 Parkwood Dr
Elkin, NC 28621-2430

Mailing address

5665 New Northside Dr
Atlanta, GA 30328-5831
Phone (404) 645-7645

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
I20240603001325 NC Practitioner - Physician Assistant 9931641289 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: zrunyon1171283@direct.unc.nchie.net

Organizations & group practices 5

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": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1558127340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831",
            "telephone_number": "404-645-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PARKWOOD DR",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212430",
            "telephone_number": "404-645-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNYON",
        "first_name": "ZAKARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkin, NC

Sources for this page

Verify at the official NPI Registry.