Active NPI
Neil Teague Mashburn, PA
- Medical Physician Assistant
- Kernersville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 101146
- Practice address
- 420 W Mountain St
Kernersville, NC 27284-2534 - Phone
- (336) 993-1618
- Fax
- (336) 993-5340
- NPI assigned
- Apr 22, 2006
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 101146 | NC | Primary |
Addresses
Primary practice location
420 W Mountain St
Kernersville, NC 27284-2534
Mailing address
2013 Middleham Dr
Kernersville, NC 27284-8650
Phone (336) 993-2460
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090123000548 | NC | Practitioner - Physician Assistant | 2163586850 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
601 N Elm St
High Point, NC 27262-4331
Phone (336) 716-2734
Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734
Hospital & facility affiliations
- High Point Regional Health System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101146 | NC | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients |
Locations
910 Worth St
Mount Airy, NC 27030
Phone (336) 786-5108
791 Jonestown Rd
Winston Salem, NC 27103
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- nmashburn2755539@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
NC
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": "1145664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469145600000",
"number": "1831155431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2013 MIDDLEHAM DR",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272848650",
"telephone_number": "336-993-2460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 W MOUNTAIN ST",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272842534",
"telephone_number": "336-993-1618",
"fax_number": "336-993-5340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASHBURN",
"first_name": "NEIL",
"middle_name": "TEAGUE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-22",
"last_updated": "2016-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NC",
"license": "101146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kernersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.