NPIMap

Individual provider Active NPI

Clare Haley Ealley, PA-C

  • Physician Assistant
  • Clemmons, NC
National Provider Identifier
1770198962
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-10250 Issued in NC
Practice address
2265 Lewisville Clemmons Rd
Clemmons, NC 27012-7462
Phone
(336) 716-8575
Fax
(336) 702-9265
NPI assigned
Sep 14, 2020
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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 0010-10250 NC Primary

Addresses

Primary practice location

2265 Lewisville Clemmons Rd
Clemmons, NC 27012-7462

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 713-0947

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chaley440989@direct.novanthealth.org

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
I20201103001533 NC Practitioner - Physician Assistant 6406266410 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2311 Lewisville Clemmons Rd
Clemmons, NC 27012-8905
Phone (336) 716-2255

2341 Lewisville Clemmons Rd
Clemmons, NC 27012-8905
Phone (336) 716-2255

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Feb 10, 2025 Accepting new patients
Emergeortho PA Physician Assistant CurrentSince Nov 7, 2022 Accepting new patients
Emergeortho PA CurrentSince Nov 7, 2022 Accepting new patients

Locations

2265 Lewisville Clemmons Rd
Ste C
Clemmons, NC 27012
Phone (336) 712-0660

4205 Ben Franklin Blvd
Durham, NC 27704
Phone (919) 477-6900

5107 Southpark Dr
Ste 104
Durham, NC 27713
Phone (919) 477-6900

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: cealley2976738@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: chaley440989@direct.novanthealth.org

Organizations & group practices 4

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 5

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": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1770198962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-713-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 LEWISVILLE CLEMMONS RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270127462",
            "telephone_number": "336-716-8575",
            "fax_number": "336-702-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EALLEY",
        "first_name": "CLARE",
        "middle_name": "HALEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chaley440989@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "4205 Ben Franklin Blvd",
            "city": "Durham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "277042143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.