Individual provider Active NPI

Nicholas Hummer Schambach, PA-C

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1740646629
Registry record updated Jun 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06145 Issued in NC
Practice address
2131 S 17TH St
Wilmington, NC 28401-7407
Phone
(910) 341-3300
Fax
(910) 251-2067
NPI assigned
Jan 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2017

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 0010-06145 NC Primary

Addresses

Primary practice location

2131 S 17TH St
Wilmington, NC 28401-7407

Mailing address

1202 Medical Center Drive
Wilmington, NC 28401
Phone (910) 341-3300

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
I20160224002410 NC Practitioner - Physician Assistant 1052616364 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Frye Emergency Medical Associates LLCGroup PAC ID 1557398609, 18 clinicians
DLP Frye Hospitalists LLCGroup PAC ID 1951702539, 46 clinicians

Practice addresses (Care Compare)

420 N Ctr St
Hickory, NC 28601-5033
Phone (704) 660-4055

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-06145NCMDPhysician Assistant

Organizations & group practices 2

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": "1452211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1740646629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DRIVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28401",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAMBACH",
        "first_name": "NICHOLAS",
        "middle_name": "HUMMER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-08",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.