Maybelle M Madlock, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001000379 Issued in NC

Practice address

10931 Raven Ridge Rd Ste 101
Raleigh, NC 27614-6499

Phone

(919) 870-6600

NPI assigned

Jan 25, 2006

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Dermatology PAGroup PAC ID 7012971609, 52 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mmadlock@aadermaffiliates.emadirect.md
• Direct secure messaging: mmadlock@ncderm.emadirect.md

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.

• Southern Dermatology, P.a.

  • Specialist
  • Raleigh, NC
  • NPI 1568415586
  Medicare reassignment Care Compare group
• Raleigh Dermatology Associates PA

  • Dermatology Physician
  • Raleigh, NC
  • NPI 1285674952
  NPD (past)
• Abington Memorial Hospital

  • Neurological Surgery Physician
  • Abington, PA
  • NPI 1386685386
  NPD (past)
• Anne Arundel Dermatology Affiliates PC

  • Dermatology Physician
  • Hunt Valley, MD
  • NPI 1083200794
  NPD (past)
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1063531929
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1740250463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23329",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10931 RAVEN RIDGE RD STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146499",
            "telephone_number": "919-870-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Springfield Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276098532",
            "country_code": "US",
            "telephone_number": "919-876-3656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 SW Cary Pkwy",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275115562",
            "country_code": "US",
            "telephone_number": "919-467-8556 x132",
            "fax_number": "919-380-1480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADLOCK",
        "first_name": "MAYBELLE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001000379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marquetta Maddox, LMT
• Thomas Wilbur Maddox, MD
• Joseph Michael Maddux, PA-C, MSHS
• Nancy Madenyika, MSW, LCSW
• Enoc Eduardo Madero, M.A.
• Whitney Madren
• Mads DME 02256
• Christopher B Madson, CNIM, AAS, R. EP
• Gabriela Magallanes, LCAS-A
• Lucy Seagraves Magda

• Physician Assistant in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.