Individual provider Active NPI

Megan Lynnette Giere, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1790077071
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08173 Issued in NC
Practice address
4909 Waters Edge Dr Ste 100
Raleigh, NC 27606-2462
Phone
(919) 589-1204
Fax
(919) 589-1264
NPI assigned
May 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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 003255 OH
Physician Assistant 363A00000X 0010-08173 NC Primary

Addresses

Primary practice location

4909 Waters Edge Dr Ste 100
Raleigh, NC 27606-2462

Mailing address

4909 Waters Edge Dr Ste 100
Raleigh, NC 27606-2462
Phone (919) 589-1204

Other names 1

  • Megan Lynnette Leach Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110801000757 OH Practitioner - Physician Assistant 9830368265 Reassigns benefits to 3 organizations
I20180926004226 NC Practitioner - Physician Assistant 9830368265 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians
Lifesource Prime IncGroup PAC ID 7810336385, 52 clinicians

Practice addresses (Care Compare)

3205 Randall Pkwy
Suite 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-08173NCMDPhysician Assistant
003255OHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource Prime Inc CurrentSince Dec 1, 2025 Accepting new patients
Lifesource of North Carolina Psychiatry CurrentSince Nov 4, 2021 Accepting new patients
Lifesource of North Carolina Psychiatry CurrentSince Nov 4, 2021 Accepting new patients
Lifesource Prime Inc CurrentSince Dec 1, 2025 Accepting new patients
Emergency Services, Inc. Past Accepting new patients

Locations

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

3205 Randall Pkwy
Wilmington, NC 28403
Phone (919) 521-0833

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1790077071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062462",
            "telephone_number": "919-589-1204",
            "fax_number": "919-589-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 WATERS EDGE DR STE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062462",
            "telephone_number": "919-589-1204",
            "fax_number": "919-589-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIERE",
        "first_name": "MEGAN",
        "middle_name": "LYNNETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-05",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "003255",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "LEACH",
            "middle_name": "LYNNETTE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.