Wallace B. Moncrief, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

100450 Issued in NC

Practice address

103 Medical Heights Dr
Morganton, NC 28655-5197

Phone

(828) 391-2014

Fax

(828) 437-1034

NPI assigned

Jul 9, 2006

Last updated

Aug 14, 2007By the provider in NPPES

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JJJEBD
• Direct secure messaging: wallace.moncrief.1@18322.direct.athenahealth.com

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.

• High Country Community Health

  • Federally Qualified Health Center (FQHC)
  • Newland, NC
  • NPI 1083979082

  Family Medicine

  Medicare reassignment NPD
• High Country Community Health

  • Federally Qualified Health Center (FQHC)
  • Connelly Springs, NC
  • NPI 1518502103
  Medicare reassignment NPD
• High Country Community Health

  • Federally Qualified Health Center (FQHC)
  • Boone, NC
  • NPI 1750646741

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1770516965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MEDICAL HEIGHTS DR",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286555197",
            "telephone_number": "828-391-2014",
            "fax_number": "828-437-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MEDICAL HEIGHTS DR",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286555197",
            "telephone_number": "828-391-2014",
            "fax_number": "828-437-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCRIEF",
        "first_name": "WALLACE",
        "middle_name": "B.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "100450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Moffitt, M.A., CCC-SLP
• Ayah Magdy Kamal Ahmed Mohamed, M.D.
• Suneel Mohammed, MD
• Masood Mohiuddin, M.D.
• Matthew Sheldon Moncrief, LPCA, NCC
• Mario Montalvo, LCAS
• Yatziry Montiel Rosales, M.A. CCC-SLP
• Laurie Moody, LCMHC, LCAS, CCS
• Carolyn Mook, M.D.
• James McDowell Moore, PH.D.

• Family Medicine Physician in Morganton, NC
• Providers in Morganton, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.