Individual provider Active NPI

Andrew Clifford Pinkerton, PA-C

  • Physician Assistant
  • North Wilkesboro, NC
National Provider Identifier
1962520742
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102623 Issued in NC
Practice address
1915 W Park Dr
Suite 103
North Wilkesboro, NC 28659-3511
Phone
(336) 838-9553
Fax
(336) 838-9563
NPI assigned
Mar 27, 2007
Last updated
Nov 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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 102623 NC Primary

Addresses

Primary practice location

1915 W Park Dr
Suite 103
North Wilkesboro, NC 28659-3511

Mailing address

1915 W Park Dr
Suite 103
North Wilkesboro, NC 28659-3511
Phone (336) 838-9553

Other identifiers 2

IdentifierTypeStateIssuer
2335816OtherNCMEDICARE PTAN, GROUP WPN
NC2753AOtherNCMEDICARE INDIVIDUAL, FOR WPN

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
I20040929001200 NC Practitioner - Physician Assistant 5395714935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1900 W Park Dr
Suite B
North Wilkesboro, NC 28659-3563
Phone (336) 903-6840

1914 W Park Dr
North Wilkesboro, NC 28659-3563
Phone (336) 903-7710

1916 W Park Dr
North Wilkesboro, NC 28659-3563
Phone (336) 838-9553

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2017 Accepting new patients
WRMC Hospital Operating Corporation Past Accepting new patients
Boomer Medical Center, Inc. Past Accepting new patients

Locations

1534 W D St
North Wilkesboro, NC 28659
Phone (336) 667-4178

1900 W Park Dr
Ste B
North Wilkesboro, NC 28659
Phone (336) 903-6840

1915 W Park Dr
Ste 103
North Wilkesboro, NC 28659
Phone (336) 838-9553

200 W Park Cir
Ste C
North Wilkesboro, NC 28659
Phone (336) 568-7700

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: apinkerton@yadkinvalleyadultmedicine.gwaydirect.com
  • Direct secure messaging: apinkerton2755227@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1962520742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 W PARK DR",
            "address_2": "SUITE 103",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593511",
            "telephone_number": "336-838-9553",
            "fax_number": "336-838-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 W PARK DR",
            "address_2": "SUITE 103",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593511",
            "telephone_number": "336-838-9553",
            "fax_number": "336-838-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKERTON",
        "first_name": "ANDREW",
        "middle_name": "CLIFFORD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN, GROUP WPN",
            "identifier": "2335816",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL, FOR WPN",
            "identifier": "NC2753A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

Verify at the official NPI Registry.