Active NPI
Anna Grace Patrick, DDS
- Dentist
- Southern Pines, NC
National Provider Identifier
1770329468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 13824
- Practice address
- 1732 Old Morganton Rd
Southern Pines, NC 28387-5185 - Phone
- (910) 519-1922
- NPI assigned
- Jul 2, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 13824 | NC | Primary |
Addresses
Primary practice location
1732 Old Morganton Rd
Southern Pines, NC 28387-5185
Mailing address
79 Pomeroy Dr
Pinehurst, NC 28374-9740
Phone (919) 605-6079
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1770329468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 POMEROY DR",
"city": "PINEHURST",
"state": "NC",
"postal_code": "283749740",
"telephone_number": "919-605-6079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1732 OLD MORGANTON RD",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283875185",
"telephone_number": "910-519-1922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "ANNA",
"middle_name": "GRACE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-02",
"last_updated": "2024-07-02",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "13824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southern Pines, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.