Evan Buck, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

180 Parkwood Dr
Elkin, NC 28621-2430

Phone

(336) 527-7000

NPI assigned

May 16, 2022

Last updated

May 16, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Yadkin Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Elkin, NC
  • NPI 1417443771
  Medicare reassignment

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1972240646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 HUNTINGTON DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PARKWOOD DR",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212430",
            "telephone_number": "336-527-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "EVAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "N",
            "address_1": "180 Parkwood Dr",
            "city": "Elkin",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286212430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• BRMG-PC
• Carl Brown
• Henry Stephen Brown, RPH
• Melissa Willard Bryant, FNP-C
• BT Heart and Vascular Center, PLLC (The Heart and Vascular Center)
• Brad Alen Bushong, D.C.
• Beverly A Byrd, M.D.
• Robert Coulter Campbell, M.D.
• Tony Wayne Canupp, MD
• Dominick John Carbone Jr., MD

• Physician Assistant in Elkin, NC
• Providers in Elkin, 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 May 16, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.