Evan Buck, PA
Individual provider Active NPI Physician Assistant · Elkin, NC
NPI 1972240646 · NPPES record last updated May 16, 2022
Key facts
- NPI
- 1972240646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 180 Parkwood Dr
Elkin, NC 28621-2430 - Phone
- (336) 527-7000
- NPI assigned
- May 16, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220727002603 | NC | Practitioner - Physician Assistant | 8123400819 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
180 Parkwood Dr
Elkin, NC 28621-2430
Mailing address
208 Huntington Dr
Chapel Hill, NC 27514-2418
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | securerecords.sanford.html |
Other providers in Elkin, NC
- BRMG-PC
- Carl Brown
- Henry Stephen Brown
- Melissa Willard Bryant
- BT Heart and Vascular Center, PLLC
- Brad Alen Bushong
- Beverly A Byrd
- Robert Coulter Campbell
- Tony Wayne Canupp
- Dominick John Carbone Jr.
All providers in Elkin, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.