Individual provider Active NPI

Carrie C. Delong, PA

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1871725556
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01937 Issued in NC
Practice address
1372 Westgate Center Dr
Winston Salem, NC 27103-2932
Phone
(336) 659-4814
Fax
(336) 768-4745
NPI assigned
Aug 14, 2009
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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 0010-01937 NC Primary

Addresses

Primary practice location

1372 Westgate Center Dr
Winston Salem, NC 27103-2932

Mailing address

PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625

Other identifiers 4

IdentifierTypeStateIssuer
1871725556MedicaidVA
NNI550AOtherNCMEDICARE PTAN
NNI550A950OtherNCMEDICARE PTAN
1871725556MedicaidNC

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
I20090928000735 NC Practitioner - Physician Assistant 5294881538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Partners PLLCGroup PAC ID 7113822420, 144 clinicians

Practice addresses (Care Compare)

1372 Westgate Ctr Dr
Winston Salem, NC 27103-2932
Phone (336) 659-4814

851 Old Winston Rd
Suite 103
Kernersville, NC 27284-8781
Phone (336) 993-9995

911 Worth St
Mount Airy, NC 27030-4459
Phone (336) 789-9447

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NPI 1508468638 CurrentSince Jun 29, 2021 Accepting new patients
Allergy Partners, PLLC CurrentSince Jun 29, 2021 Accepting new patients

Locations

851 Old Winston Rd
Ste 103
Kernersville, NC 27284
Phone (336) 993-9995

911 Worth St
Mount Airy, NC 27030
Phone (336) 786-8880

116 Wilkesboro Ave
Ste C
North Wilkesboro, NC 28659
Phone (336) 667-6193

420 Mocksville Ave
Salisbury, NC 28144
Phone (704) 431-4253

1372 Westgate Center Dr
Winston Salem, NC 27103
Phone (336) 659-4814

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, 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": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1871725556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1372 WESTGATE CENTER DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032932",
            "telephone_number": "336-659-4814",
            "fax_number": "336-768-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELONG",
        "first_name": "CARRIE",
        "middle_name": "C.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871725556",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NNI550A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NNI550A950",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871725556",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.