NPIMap

Individual provider Active NPI

Abigail H Cannata

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1700586195
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-13061 Issued in NC
Practice address
1319 Avon St
Fayetteville, NC 28304-4423
Phone
(910) 729-6552
NPI assigned
Mar 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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 0010-13061 NC Primary

Addresses

Primary practice location

1319 Avon St
Fayetteville, NC 28304-4423

Mailing address

1319 Avon St
Fayetteville, NC 28304-4423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230519002956 NC Practitioner - Physician Assistant 9335505197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Georgetown University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Id Care(R) - Infectious Diseases Specialty Practice PAGroup PAC ID 0345529988, 10 clinicians

Practice addresses (Care Compare)

1319 Avon St
Fayetteville, NC 28304-4423
Phone (910) 729-6552

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1700586195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 AVON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 AVON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044423",
            "telephone_number": "910-729-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNATA",
        "first_name": "ABIGAIL",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.