NPIMap

Individual provider Active NPI

Andrea R Ward, PA-C

  • Surgical Physician Assistant
  • Raleigh, NC
National Provider Identifier
1780808931
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0010-01988 Issued in NC
Practice address
2800 Blue Ridge Rd
Suite 403
Raleigh, NC 27607-6478
Phone
(919) 784-7110
Fax
(919) 784-7111
NPI assigned
Apr 12, 2007
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 890 SC
Surgical Physician Assistant 363AS0400X 2024045093 MO
Surgical Physician Assistant 363AS0400X 0010-01988 NC Primary

Addresses

Primary practice location

2800 Blue Ridge Rd
Suite 403
Raleigh, NC 27607-6478

Mailing address

2800 Blue Ridge Rd
Suite 403
Raleigh, NC 27607-6478
Phone (919) 784-7110

Other practice location 1

222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone (803) 329-1234

Other practice location 2

1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-3960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241015000294 SC Practitioner - Physician Assistant 3274673801 Reassigns benefits to 2 organizations
I20241121002576 MO Practitioner - Physician Assistant 3274673801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024045093MOMDSurgical Physician Assistant
0010-01988NCMDSurgical Physician Assistant
890SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Nov 13, 2024 Accepting new patients
Self Medical Group CurrentSince Dec 1, 2025 Accepting new patients
Self Medical Group CurrentSince Dec 1, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 13, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 13, 2024 Accepting new patients
Firsthealth of the Carolinas, Inc Past Accepting new patients
Rex Hospital, Inc. Past Accepting new patients
Rex Hospital Inc Past Accepting new patients
Self Medical Group Past Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1506 Spring St
Greenwood, SC 29646
Phone (864) 227-3117

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Organizations & group practices 10

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 9

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1780808931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 BLUE RIDGE RD",
            "address_2": "SUITE 403",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076478",
            "telephone_number": "919-784-7110",
            "fax_number": "919-784-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BLUE RIDGE RD",
            "address_2": "SUITE 403",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076478",
            "telephone_number": "919-784-7110",
            "fax_number": "919-784-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Herlong Ave S",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297321158",
            "country_code": "US",
            "telephone_number": "803-329-1234",
            "fax_number": "803-328-1785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1235 E Cherokee St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658042203",
            "country_code": "US",
            "telephone_number": "417-820-3960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARD",
        "first_name": "ANDREA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "890",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2024045093",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-01988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.