Individual provider Active NPI

Anna Succop Reigel, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1740889203
Registry record updated Jul 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5950 Fairview Rd Ste 808
Charlotte, NC 28210-2110
Phone
(980) 867-4440
NPI assigned
Oct 25, 2020
Last updated
Jul 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-10293 NC
Physician Assistant 363A00000X NC Primary

Addresses

Primary practice location

5950 Fairview Rd Ste 808
Charlotte, NC 28210-2110

Mailing address

13207 Caite Ridge Rd
Davidson, NC 28036-0450
Phone (704) 737-1945

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
I20210831001268 NC Practitioner - Physician Assistant 6901202944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2587 Ravenhill Dr
Fayetteville, NC 28303-5451
Phone (910) 323-1543

5950 Fairview Rd
Suite 808
Charlotte, NC 28210-2110
Phone (980) 867-4440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Best Day Psychiatry and Counseling, PC Psychiatry CurrentSince Aug 9, 2021 Accepting new patients
Best Day Psychiatry and Counseling, PC Psychiatry CurrentSince Aug 9, 2021 Accepting new patients
Best Day Psychiatry and Counseling, PC Psychiatry Past Accepting new patients
MC Family Medical, PLLC PastSince Nov 1, 2020 Accepting new patients
FCRX Inc PastSince Nov 1, 2020 Accepting new patients

Locations

5950 Fairview Rd
Ste 808
Charlotte, NC 28210
Phone (910) 323-1545

2587 Ravenhill Dr
Fayetteville, NC 28303
Phone (910) 323-1545

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1603584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657929600000",
    "number": "1740889203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13207 CAITE RIDGE RD",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280360450",
            "telephone_number": "704-737-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 FAIRVIEW RD STE 808",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282102110",
            "telephone_number": "980-867-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIGEL",
        "first_name": "ANNA",
        "middle_name": "SUCCOP",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-25",
        "last_updated": "2022-07-16",
        "certification_date": "2022-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-10293",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.