Individual provider Active NPI

Darrell Kevin Tegtmeyer, MPAS, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1831186360
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12999 Issued in NC
Practice address
2085 Frontis Plaza Blvd
Winston Salem, NC 27103-5614
Phone
(704) 316-4136
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-12999 NC Primary
Medical Physician Assistant 363AM0700X 2822 SC

Addresses

Primary practice location

2085 Frontis Plaza Blvd
Winston Salem, NC 27103-5614

Mailing address

613 Bart Bellamy LN
Cottageville, SC 29435-3034
Phone (843) 321-5927

Other practice location 1

1818 Henderson St
Columbia, SC 29201-2619
Phone (843) 321-5927

Other practice location 2

10160 Dorchester Road
Summerville, SC 29485-8527
Phone (843) 871-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, 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
I20221208001743 SC Practitioner - Physician Assistant 5698144905 Reassigns benefits to 1 organization
I20260414000111 NC Practitioner - Physician Assistant 5698144905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
NH Digital Health Services LLCGroup PAC ID 9537588934, 37 clinicians
Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

2085 Frontis Plaza Blvd
Winston Salem, NC 27103-5614
Phone (704) 316-4136

6167 Braided Mane Pass SW
Aiken, SC 29803-7839
Phone (803) 648-1464

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-12999NCMDPhysician Assistant
2822SCMDMedical Physician 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.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1831186360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 BART BELLAMY LN",
            "city": "COTTAGEVILLE",
            "state": "SC",
            "postal_code": "294353034",
            "telephone_number": "843-321-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 FRONTIS PLAZA BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035614",
            "telephone_number": "704-316-4136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1818 Henderson St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292012619",
            "country_code": "US",
            "telephone_number": "843-321-5927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10160 Dorchester Road",
            "address_purpose": "LOCATION",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858527",
            "country_code": "US",
            "telephone_number": "843-871-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEGTMEYER",
        "first_name": "DARRELL",
        "middle_name": "KEVIN",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12999",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2822",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.