Individual provider Active NPI

Julie Allison Everidge, PA

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1821319070
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-02360 Issued in NC
Practice address
4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Phone
(336) 251-1114
Fax
(336) 251-1115
NPI assigned
Jun 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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 0010-02360 NC Primary

Addresses

Primary practice location

4692 Brownsboro Rd
Winston Salem, NC 27106-3410

Mailing address

4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Phone (336) 251-1114

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100706000679 NC Practitioner - Physician Assistant 4981735040 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Eldercare PAGroup PAC ID 0648184705, 236 clinicians
Curana Health of North Carolina PLLCGroup PAC ID 1850774332, 274 clinicians

Practice addresses (Care Compare)

1240 Arbor Rd
Winston Salem, NC 27104-1106
Phone (336) 724-7921

4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Phone (336) 251-1114

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-02360NCMDPhysician Assistant

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1821319070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4692 BROWNSBORO RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063410",
            "telephone_number": "336-251-1114",
            "fax_number": "336-251-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4692 BROWNSBORO RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063410",
            "telephone_number": "336-251-1114",
            "fax_number": "336-251-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERIDGE",
        "first_name": "JULIE",
        "middle_name": "ALLISON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.