Phyllis Mack Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

101795 Issued in NC

Practice address

1604 Medical Dr
Laurinburg, NC 28352-5524

Phone

(704) 323-2000

NPI assigned

Feb 26, 2007

Sex

Female

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

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

Specialty

Physician Assistant

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

OrthocarolinaGroup PAC ID 2062316821, 288 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scotland Memorial Hospital Hospital, Laurinburg, NC, CCN 340008
• Southeastern Regional Medical Center Hospital, Lumberton, NC, CCN 340050

Merit-based Incentive Payment System (MIPS)

Final score

94 of 100Reported as apm

Quality

81.63

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Orthocarolina

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1497704217

  NC

  Medicare reassignment Care Compare group
• Orthocarolina

  • Orthopaedic Surgery Physician
  • King, NC
  • NPI 1982020202

  Physician Assistant

  NPD
• Orthocarolina

  • Orthopaedic Surgery Physician
  • Indian Land, SC
  • NPI 1619641453

  Physician Assistant

  NPD
• Orthocarolina

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1104843978

  Physician Assistant

  NPD (past)
• Scotland Orthopedics, PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Pembroke, NC
  • NPI 1033366885
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Scotland Memorial Hospital Inc

  • General Acute Care Hospital
  • Laurinburg, NC
  • NPI 1457345597

  Hospital

  Care Compare affiliation
• Southeastern Regional Medical Center

  • General Acute Care Hospital
  • Lumberton, NC
  • NPI 1427030774

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1699801142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093239",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 MEDICAL DR",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525524",
            "telephone_number": "704-323-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PHYLLIS",
        "middle_name": "MACK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Graham Wilkins, FNP-C, PMHNP-BC
• William R Armstrong Jr
• Alejandra Williams
• Bailey Forbes Williams, RPH
• Lasandra Williams
• Kaytline Leeann Wilt
• Ava Loretta Wishon
• Wolonick Family Practice, P.a.
• Lindsay Woodberry, PHARM D
• Woodbranch Child and Family Support Services, Inc

• All providers in Laurinburg, NC
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; 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.

Verify at the official NPI Registry.