NPIMap

Individual provider Active NPI

Reinaldo Nodal Jr., PAC

  • Physician Assistant
  • Asheboro, NC
National Provider Identifier
1861820243
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05145 Issued in NC
Practice address
375 Sunset Ave
Asheboro, NC 27203-5611
Phone
(336) 625-4215
Fax
(336) 626-0919
NPI assigned
Oct 23, 2013
Last updated
Nov 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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 PA9107554 FL
Physician Assistant 363A00000X 0010-05145 NC Primary

Addresses

Primary practice location

375 Sunset Ave
Asheboro, NC 27203-5611

Mailing address

1701 Westchester Dr
Ste 850
High Point, NC 27262-7008
Phone (336) 802-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150314000046 NC Practitioner - Physician Assistant 6305073925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians

Practice addresses (Care Compare)

223 W Ward St
Suite B
Asheboro, NC 27203-5423
Phone (336) 702-1731

770 Highland Oaks Dr
Winston Salem, NC 27103-7105
Phone (336) 765-5250

905 Phillips Ave
High Point, NC 27262-7075
Phone (336) 802-2040

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Health Network LLC CurrentSince Nov 17, 2014 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Nov 17, 2014 Accepting new patients
Cornerstone Health Care PA Past Accepting new patients

Locations

375 Sunset Ave
Asheboro, NC 27203
Phone (336) 625-4215

1701 Westchester Dr
Ste 850
High Point, NC 27262
Phone (336) 802-2400

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

Interoperability endpoints

  • Direct secure messaging: rnodal2755461@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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 6

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": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1861820243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DR",
            "address_2": "STE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627008",
            "telephone_number": "336-802-2400",
            "fax_number": "336-802-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 SUNSET AVE",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035611",
            "telephone_number": "336-625-4215",
            "fax_number": "336-626-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NODAL",
        "first_name": "REINALDO",
        "name_suffix": "Jr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-23",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107554",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheboro, NC

Sources for this page

Verify at the official NPI Registry.