NPIMap

Individual provider Active NPI

Tod Randall Ward, PA-C

  • Physician Assistant
  • Lexington, NC
National Provider Identifier
1922054261
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103942 Issued in NC
Practice address
1977 Cotton Grove Rd
Lexington, NC 27292-5721
Phone
(336) 443-6041
Fax
(336) 443-6042
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 103942 NC
Physician Assistant 363A00000X 103942 NC Primary

Addresses

Primary practice location

1977 Cotton Grove Rd
Lexington, NC 27292-5721

Mailing address

PO Box 601843
Charlotte, NC 28260-1843

Other practice location 1

601 N Elm St
High Point, NC 27262-4331
Phone (336) 878-6115

Other identifiers 2

IdentifierTypeStateIssuer
199311OtherMEDCOST
7753971OtherAETNA

Other names 1

  • Tod Randall Ward Professional name

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
I20040810000873 NC Practitioner - Physician Assistant 2567434525 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

1977 Cotton Grove Rd
Lexington, NC 27292-5721
Phone (336) 443-6041

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103942NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Medicorp Enterprises, LLC CurrentSince Feb 21, 2022 Accepting new patients
CDT Healthcare CurrentSince Dec 21, 2020 Accepting new patients
Carolina Medicorp Enterprises Inc Past Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients
Johnson Neurological Clinic, Inc. Past Accepting new patients

Locations

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

1977 Cotton Grove Rd
Lexington, NC 27292
Phone (336) 243-3000

101 Walmart Supercenter
Siler City, NC 27344
Phone (919) 663-3911

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

Interoperability endpoints

  • Direct secure messaging: tward201088@direct.novanthealth.org

Organizations & group practices 12

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1922054261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 COTTON GROVE RD",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272925721",
            "telephone_number": "336-443-6041",
            "fax_number": "336-443-6042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Elm St",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272624331",
            "country_code": "US",
            "telephone_number": "336-878-6115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARD",
        "first_name": "TOD",
        "middle_name": "RANDALL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103942",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "199311",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7753971",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOD",
            "last_name": "WARD",
            "middle_name": "RANDALL",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lexington, NC

Sources for this page

Verify at the official NPI Registry.