Individual provider Active NPI

Levy Nathan Wiseman-Floyd, PA-C

  • Physician Assistant
  • Durham, NC
National Provider Identifier
1588376149
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12829 Issued in NC
Practice address
5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102
Phone
(929) 391-7202
NPI assigned
Dec 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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 0010-12829 NC Primary

Addresses

Primary practice location

5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102

Mailing address

5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102
Phone (919) 391-7202

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
I20230627002602 NC Practitioner - Physician Assistant 6901264605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10420 Park Rd
Suite 300
Charlotte, NC 28210-8502
Phone (980) 237-4766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Animo Sano Psychiatry PLLC Psychiatry CurrentSince Jul 1, 2026 Accepting new patients

Locations

2741 Campus Walk Ave
Bldg 400
Durham, NC 27705
Phone (919) 909-1230

5501 Fortunes Ridge Dr
Ste P
Durham, NC 27713
Phone (919) 319-7202

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": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1588376149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 FORTUNES RIDGE DR STE P",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136102",
            "telephone_number": "919-391-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 FORTUNES RIDGE DR STE P",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136102",
            "telephone_number": "929-391-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN-FLOYD",
        "first_name": "LEVY",
        "middle_name": "NATHAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-14",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.