Individual provider Active NPI

Hunter Grant Shore, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Lenoir, NC
National Provider Identifier
1649989757
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1041 Morganton Blvd SW Ste 100
Lenoir, NC 28645-5605
Phone
(828) 323-2460
NPI assigned
Nov 17, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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 Primary

Addresses

Primary practice location

1041 Morganton Blvd SW Ste 100
Lenoir, NC 28645-5605

Mailing address

1041 Morganton Blvd SW # 100
Lenoir, NC 28645-5605
Phone (828) 323-2460

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
I20230111000310 NC Practitioner - Physician Assistant 8729458609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DLP Frye Medical Group LLCGroup PAC ID 8123397601, 125 clinicians

Practice addresses (Care Compare)

1041 Morganton Blvd SW
Lenoir, NC 28645-5605
Phone (828) 323-2460

915 Tate Blvd SE
Hickory, NC 28602-4042

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Frye Medical Group LLC CurrentSince Mar 1, 2023 Accepting new patients
DLP Frye Medical Group LLC Physician Assistant CurrentSince Mar 1, 2023 Accepting new patients
DLP Frye Medical Group LLC Physician Assistant Past Accepting new patients

Locations

915 Tate Blvd SE
Ste 182
Hickory, NC 28602
Phone (828) 322-2005

1041 Morganton Blvd SW
#100
Lenoir, NC 28645
Phone (828) 323-2460

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: hunter.shore.1@15786.direct.athenahealth.com

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.

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": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1649989757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 MORGANTON BLVD SW # 100",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455605",
            "telephone_number": "828-323-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 MORGANTON BLVD SW STE 100",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286455605",
            "telephone_number": "828-323-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "HUNTER",
        "middle_name": "GRANT",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-17",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir, NC

Sources for this page

Verify at the official NPI Registry.