Individual provider Active NPI

Angela Marie Dorry, PA-C

  • Medical Physician Assistant
  • Durham, NC
National Provider Identifier
1922253103
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-01572 Issued in NC
Practice address
508 Fulton St
Durham, NC 27705-3875
Phone
(919) 286-0411
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 001001572 NC
Medical Physician Assistant 363AM0700X 0010-01572 NC Primary

Addresses

Primary practice location

508 Fulton St
Durham, NC 27705-3875

Mailing address

5 Woodbine CT
Durham, NC 27713-9491
Phone (419) 889-4832

Other practice location 1

1390 Capital Blvd
Raleigh, NC 27603-1118
Phone (919) 256-2185

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
I20201209002053 NC Order and Referring Only - Physician Assistant 6800207325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001001572NCMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1922253103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WOODBINE CT",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277139491",
            "telephone_number": "419-889-4832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-0411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1390 Capital Blvd",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276031118",
            "country_code": "US",
            "telephone_number": "919-256-2185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORRY",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001001572",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-01572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.