Matthew R Ewerling, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-03764 Issued in NC

Practice address

1638 Owen Dr
Fayetteville, NC 28304-3424

Phone

(910) 615-4372

NPI assigned

May 8, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

State licenses

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.

• Robeson Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Lumberton, NC
  • NPI 1801375373
  Medicare reassignment

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1992064299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 RUSH RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283054921",
            "telephone_number": "516-398-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWERLING",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014536-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evergreen Health Services, LLC
• Evolution Wellness Center, PLLC
• Evolve Counseling Services, Plla
• Evolve Therapy & Wellness, PLLC
• Katelyn Mary Evoy
• Stefanie Stellfox Ewert, RN
• Angela Ewing
• Excel Tutoring & Personal Development
• Excel Tutoring and Personal Development
• Express Discount Pharmacy LLC

• Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, 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 Dec 31, 2012; 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.