Individual provider Active NPI

Hattie Danielle McCall, PA-C

  • Physician Assistant
  • Southern Pines, NC
National Provider Identifier
1861987117
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09029 Issued in NC
Practice address
195 W Illinois Ave
Southern Pines, NC 28387-5808
Phone
(910) 692-2444
NPI assigned
Jun 28, 2018
Last updated
Feb 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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 0010-09029 NC Primary

Addresses

Primary practice location

195 W Illinois Ave
Southern Pines, NC 28387-5808

Mailing address

195 W Illinois Ave
Southern Pines, NC 28387-5808
Phone (910) 692-2444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 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
I20240911004458 WA Practitioner - Physician Assistant 8729472303 Reassigns benefits to 1 organization
I20240912002048 OR Practitioner - Physician Assistant 8729472303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.85 of 100Reported as group
Quality
84.92
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as group
Quality
81.54
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-09029NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Banks Professional Services, LLC CurrentSince Feb 25, 2022 Accepting new patients
Vidant Medical Group LLC CurrentSince Feb 25, 2022 Accepting new patients
Northwest Acute Care Specialists PC CurrentSince Sep 1, 2024 Accepting new patients
Sandhills Pediatrics PastSince Dec 22, 2019 Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1861987117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 W ILLINOIS AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875808",
            "telephone_number": "910-692-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 W ILLINOIS AVE",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875808",
            "telephone_number": "910-692-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALL",
        "first_name": "HATTIE",
        "middle_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southern Pines, NC

Sources for this page

Verify at the official NPI Registry.