Marcy Davenport Eaton, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-06816 Issued in NC

Practice address

935 Shotwell Rd
Suite 108
Clayton, NC 27520-5597

Phone

(919) 359-2667

NPI assigned

Nov 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Lincoln Memorial University Medical Department, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.09 of 100Reported as group

Quality

65.78

Improvement activities

40

Cost

76.37

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Fastmed P.C.

  • Family Medicine Physician
  • Durham, NC
  • NPI 1629841788
  Medicare reassignment Care Compare group
• Fastmed Primary Care, P.C.

  • Family Medicine Physician
  • Fayetteville, NC
  • NPI 1912774423
  NPD (past)

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1902348451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 FILLGATE DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 SHOTWELL RD",
            "address_2": "SUITE 108",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205597",
            "telephone_number": "919-359-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "MARCY",
        "middle_name": "DAVENPORT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-15",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Duperon, LMFTA
• William C Durant, MD
• Durham Vamc
• Elfreda Ami Dzukey
• Early Speech Services.
• Andrea Eaves, LCSW
• Edc Drug Stores Inc
• Edward T. Kryn, MD, PA
• Bryan Terence Edwards, PA-C
• William Samuel Eggleston, OD

• Physician Assistant in Clayton, NC
• Providers in Clayton, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.

Verify at the official NPI Registry.