| Angela Lynn Booth, PA | |
|
615 Shipyard Blvd, Wilmington, NC 28412-6431 | |
| (910) 343-0145 | |
| (910) 202-9966 |
| Full Name | Angela Lynn Booth |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 10 Years |
| Location | 615 Shipyard Blvd, Wilmington, North Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174971600 | NPI | - | NPPES |
| 1174971600 | Medicaid | NC | |
| 3542PA | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 001007254 (North Carolina) | Secondary |
| 363A00000X | Physician Assistant | 001007254 (North Carolina) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Coastal Horizons Center, Inc. | 9739267964 | 50 |
| Belonging Medical Group Pllc | 8022443878 | 39 |
| Entity Name | Coastal Horizons Center, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922022607 PECOS PAC ID: 9739267964 Enrollment ID: O20080429000046 |
| Entity Name | Brunswick Physician Partners PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457822264 PECOS PAC ID: 2062752470 Enrollment ID: O20190321002645 |
| Entity Name | Piedmont Triad Physicians PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295206464 PECOS PAC ID: 6406197334 Enrollment ID: O20190403000344 |
| Entity Name | Kernersville Emergency Group, PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750852034 PECOS PAC ID: 3375885429 Enrollment ID: O20190422001205 |
| Entity Name | Tanglewood Park Physicians PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093286379 PECOS PAC ID: 3476895129 Enrollment ID: O20190429001041 |
| Entity Name | Belonging Medical Group PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912482787 PECOS PAC ID: 8022443878 Enrollment ID: O20241029003061 |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Lynn Booth, PA 615 Shipyard Blvd, Wilmington, NC 28412-6431 Ph: (910) 343-0145 | Angela Lynn Booth, PA 615 Shipyard Blvd, Wilmington, NC 28412-6431 Ph: (910) 343-0145 |
Robin Elizabeth Jendrazak, OPA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2716 Ashton Dr, Wilmington, NC 28412 Phone: 910-332-3800 Fax: 910-332-3833 |
Grace Ellen Russell, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 120 Gazebo Ct, Wilmington, NC 28409 Phone: 910-264-9025 |
Crystal Dawn Hill, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2421 Silver Stream Ln, Wilmington, NC 28401 Phone: 910-341-3300 Fax: 910-251-8824 |
Rya Elisabeth Lawrence, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4402 Shipyard Blvd, Wilmington, NC 28403 Phone: 910-791-0075 Fax: 910-791-9674 |
Talia Francesca Marie Mcdonough, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1988 S 16th St, Wilmington, NC 28401 Phone: 910-662-8440 Fax: 910-795-4826 |
Hannah Salefsky, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6727 Parker Farm Dr, Wilmington, NC 28405 Phone: 910-772-0370 Fax: 910-256-5985 |
Mr. Grayson Brent Mayberry, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1415 Physicians Dr, Wilmington, NC 28401 Phone: 910-662-9500 Fax: 910-662-9501 |