Individual provider Active NPI

Molly Colleen Fike

  • Medical Physician Assistant
  • Raleigh, NC
National Provider Identifier
1730651704
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-09926 Issued in NC
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone
(919) 231-8253
NPI assigned
Jan 1, 2019
Last updated
Nov 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-09926 NC
Physician Assistant 363A00000X C07096 MD
Medical Physician Assistant 363AM0700X C0007096 MD
Medical Physician Assistant 363AM0700X 09926 NC
Medical Physician Assistant 363AM0700X 0010-09926 NC Primary

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1231

Mailing address

5218 Strathmore Ave
North Bethesda, MD 20852-3482

Other practice location 1

100 E Carroll St
Salisbury, MD 21801-5493
Phone (800) 749-5191

Other identifiers 1

IdentifierTypeStateIssuer
1730651704MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, NC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190205002451 MD Practitioner - Physician Assistant 0648518399 Reassigns benefits to 2 organizations
I20200805000742 DC Practitioner - Physician Assistant 0648518399 Reassigns benefits to 1 organization
I20210413001620 NC Practitioner - Physician Assistant 0648518399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

1900 Kildaire Farm Rd
Cary, NC 27518-6616
Phone (919) 350-8000

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-7270

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C07096MDMDPhysician Assistant
0010-09926NCMDPhysician Assistant
C0007096MDMDMedical Physician Assistant
09926NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Apr 26, 2021 Accepting new patients
Mep Observation Services LLC Physician Assistant CurrentSince Nov 30, 2020 Accepting new patients
Tidalhealth Peninsula Regional, Inc. Physician Assistant CurrentSince Jan 1, 2018 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Apr 26, 2021 Accepting new patients
Tidalhealth Peninsula Regional, Inc. CurrentSince Jan 1, 2018 Accepting new patients

Locations

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

106 Milford St
Ste 201
Salisbury, MD 21804
Phone (410) 543-1616

145 E Carroll St
Salisbury, MD 21801
Phone (410) 546-6400

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Interoperability endpoints

  • Direct secure messaging: mfike348156@directhisp.wakemed.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1546300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1730651704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5218 STRATHMORE AVE",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208523482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-231-8253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Carroll St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218015493",
            "country_code": "US",
            "telephone_number": "800-749-5191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIKE",
        "first_name": "MOLLY",
        "middle_name": "COLLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-01",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09926",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C07096",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0007096",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "09926",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-09926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730651704",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.