Individual provider Active NPI

Nicole Taylor Drobner, PA-C

  • Medical Physician Assistant
  • Rocky Mount, NC
National Provider Identifier
1629748488
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-11448 Issued in NC
Practice address
91 Enterprise Dr
Rocky Mount, NC 27804-9590
Phone
(252) 937-0351
Fax
(252) 451-0056
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-11448 NC Primary

Addresses

Primary practice location

91 Enterprise Dr
Rocky Mount, NC 27804-9590

Mailing address

261 Cezanne Dr
Blowing Rock, NC 28605-9632
Phone (954) 849-4826

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
I20211112001598 NC Practitioner - Physician Assistant 5698164697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

7510 Ramble Way
Suite 107
Raleigh, NC 27616-4305
Phone (919) 747-3033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-11448NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boice-Willis Clinic, PA CurrentSince Nov 1, 2021 Accepting new patients
Boice-Willis Clinic PA CurrentSince Nov 1, 2021 Accepting new patients

Locations

91 Enterprise Dr
Rocky Mount, NC 27804
Phone (252) 451-3100

901 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0200

Organizations & group practices 3

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1629748488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 CEZANNE DR",
            "city": "BLOWING ROCK",
            "state": "NC",
            "postal_code": "286059632",
            "telephone_number": "954-849-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 ENTERPRISE DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278049590",
            "telephone_number": "252-937-0351",
            "fax_number": "252-451-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DROBNER",
        "first_name": "NICOLE",
        "middle_name": "TAYLOR",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-11448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.