Active NPI
Amanda Raya Pardon, MD
- Neurology Physician
- Wilmington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 1044456
- Practice address
- 1509 Doctors Cir BLDG C
Wilmington, NC 28401-7403 - Phone
- (910) 662-7500
- Fax
- (910) 662-7501
- NPI assigned
- Jun 16, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurocritical Care Physician | 2084A2900X | ME124831 | FL | |
| Neurocritical Care Physician | 2084A2900X | NCC4114 | NC | |
| Neurology Physician | 2084N0400X | ME124831 | FL | |
| Neurology Physician | 2084N0400X | 1044456 | NC | Primary |
Addresses
Primary practice location
1509 Doctors Cir BLDG C
Wilmington, NC 28401-7403
Mailing address
PO Box 936857
Atlanta, GA 31193-6857
Phone (910) 662-7500
Other practice location 1
800 Prudential Dr
Tower B 11TH Floor
Jacksonville, FL 32207-8202
Phone (904) 388-6518
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015345500 | Medicaid | FL |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Washington University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1509 Doctors Cir
BLDG C
Wilmington, NC 28401-7403
Phone (910) 662-7550
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NCC4114 | NC | MD | Neurocritical Care Physician |
| 1044456 | NC | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group Coastal Region, LLC | Current | Accepting new patients | |
| NMG Health Services LLC | Current | Accepting new patients | |
| Novant Health Medical Group Coastal Region, LLC | Neurology | Current | Accepting new patients |
| New Hanover Medical Group PA | Past | Accepting new patients | |
| Baptist Neurology Inc | Neurology | Past | Accepting new patients |
Locations
800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164
1515 Doctors Cir
Bldg A
Wilmington, NC 28401
1509 Doctors Cir
Bldg C
Wilmington, NC 28401
Phone (910) 662-7550
Interoperability endpoints
- apardon1461192@direct.novanthealth.org
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 and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Wilmington, NC
- NPI 1649865791
-
- Maternal & Fetal Medicine Physician
- Bolivia, NC
- NPI 1558242495
-
- Neurology Physician
- Wilmington, NC
- NPI 1316523822
-
- Family Medicine Physician
- Wilmington, NC
- NPI 1992751374
-
- Neurology Physician
- Jacksonville, FL
- NPI 1598995599
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wilmington, NC
- NPI 1376139139
-
- General Acute Care Hospital
- Jacksonville, NC
- NPI 1679535496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655424000000",
"number": "1558598631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 936857",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311936857",
"telephone_number": "910-662-7500",
"fax_number": "910-662-7501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1509 DOCTORS CIR BLDG C",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284017403",
"telephone_number": "910-662-7500",
"fax_number": "910-662-7501"
}
],
"practiceLocations": [
{
"address_1": "800 Prudential Dr",
"address_2": "TOWER B 11TH FLOOR",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322078202",
"country_code": "US",
"telephone_number": "904-388-6518",
"fax_number": "904-384-1005",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PARDON",
"first_name": "AMANDA",
"middle_name": "RAYA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-16",
"last_updated": "2022-06-17",
"certification_date": "2022-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084A2900X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurocritical Care",
"state": "FL",
"license": "ME124831",
"primary": false
},
{
"code": "2084A2900X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurocritical Care",
"state": "NC",
"license": "NCC4114",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "FL",
"license": "ME124831",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NC",
"license": "1044456",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "015345500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.