Mark Eldridge, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

101816 Issued in NC

Practice address

1725 Tarboro St SW
Wilson, NC 27893-3428

Phone

(252) 237-2891

Fax

(252) 237-0115

NPI assigned

Apr 10, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: meldridge@easterncarolinapediatrics.opdirect.net

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1578686804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 SAINT GEORGES DR N",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278969176",
            "telephone_number": "252-237-2891",
            "fax_number": "252-237-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 TARBORO ST SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933428",
            "telephone_number": "252-237-2891",
            "fax_number": "252-237-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDRIDGE",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "101816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Wilson, NC
• Providers in Wilson, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.