Active NPI
Angela Rachelle Miedema, PA-C
- Physician Assistant
- Pinehurst, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-09633
- Practice address
- 150 Ivey LN Ste a
Pinehurst, NC 28374-9817 - Phone
- (910) 215-5200
- NPI assigned
- Jan 1, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10001954A | IN | |
| Physician Assistant | 363A00000X | 0010-09633 | NC | Primary |
Addresses
Primary practice location
150 Ivey LN Ste a
Pinehurst, NC 28374-9817
Mailing address
PO Box 896208
Charlotte, NC 28289-6208
Phone (910) 715-1010
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200310002363 | NC | Practitioner - Physician Assistant | 8628372745 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- FHPG LLC
Practice addresses (Care Compare)
522 Allen St
Suite 203
Troy, NC 27371-2861
Phone (910) 571-5170
Hospital & facility affiliations
- Firsthealth Montgomery Memorial Hosp
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.84 of 100
- Quality
- 79.14
- Promoting interoperability
- 92
- Improvement activities
- 40
- Cost
- 80.32
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10001954A | IN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCPC-8, LLC | Family Medicine | Current | Accepting new patients |
| FHPG, LLC | Family Medicine | Current | Accepting new patients |
| MCPC-8, LLC | Family Medicine | Current | Accepting new patients |
| FHPG, LLC | Family Medicine | Current | Accepting new patients |
| MCPC-8, LLC | Family Medicine | Past | Accepting new patients |
Locations
208 W Salisbury St
Ste A
Asheboro, NC 27203
Phone (336) 523-0040
1021 W Hamlet Ave
Hamlet, NC 28345
Phone (910) 417-4100
150 Ivey Ln
Ste A
Pinehurst, NC 28374
Phone (910) 215-5200
4565 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-5100
1602 Westover Dr
Sanford, NC 27330
Phone (919) 897-2250
522 Allen St
Ste 203
Troy, NC 27371
Phone (910) 571-5151
7473 NC 22 Hwy
Whispering Pines, NC 28327
Phone (910) 215-5100
Interoperability endpoints
- amiedema99380@firsthealth.direct-ci.net
Organizations & group practices 7
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.
Hospital & facility affiliations 1
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": "1451606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580169600000",
"number": "1629434980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 896208",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282896208",
"telephone_number": "910-715-1010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 IVEY LN STE A",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283749817",
"telephone_number": "910-215-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIEDEMA",
"first_name": "ANGELA",
"middle_name": "RACHELLE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-01",
"last_updated": "2020-01-28",
"certification_date": "2020-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10001954A",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-09633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinehurst, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.