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NPI 1396015939ActiveOrganization· Physician Assistant, Medical· Wilmington, NC
Physician Assistant, Medical in Wilmington, North Carolina, registered in NPPES in January 2012. The authorized official on file is Jeremy Pepper, PA-C, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1396015939 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 11, 2012 |
| Last updated in NPPES | Jul 20, 2022 |
| Certified by provider | Jul 20, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | NC103010 | NC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NC) |
|---|
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