MR. O'LAF SORENTO MASSENBURG (NPI# 1013114701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013114701 |
| Entity Type | Individual |
| Full Name | MR. O'LAF SORENTO MASSENBURG |
| Credential | PA-C |
| Practice Address |
371 Nc Highway 65 Wentworth NC 27375 |
| Mailing Address |
1309 Lees Chapel Road Greensboro NC 27455-2601 |
| Practice Telephone | 3363428143 |
| Practice Fax Number | 3363428356 |
| Mailing Telephone | 3362865505 |
| Mailing Fax Number | 3362865583 |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-04-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 101117 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
101117 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
371 NC HIGHWAY 65 |
| City | WENTWORTH |
| State | NC |
| Zip Code | 27375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306947445 | Rockingham County Finance Office | Clinic/Center | 371 Nc Highway 65, Wentworth, NC 27375 | 2006-09-25 |
| 1801158761 | Onitisha V Anders | Nurse Practitioner | 371 Nc Highway 65, Wentworth, NC 27375 | 2012-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982971974 | Shatanya L Walker | Counselor | 335 County Home Rd., Wentworth, NC 27375 | 2011-11-19 |
| 1013052471 | Annette Elizabeth Jones | Counselor | 405 Nc Hwy 65, Wentworth, NC 27375 | 2007-02-21 |
| 1487722344 | Anita I Knight | Registered Nurse | 1105 Nc 65, Wentworth, NC 27375 | 2006-11-30 |
| 1750462131 | Thomas K Johnstone | Physician Assistant | 371 Nc 65 Hwy, Wentworth, NC 27375 | 2006-10-18 |
| 1538566815 | Evelyn Reed | Registered Nurse | 405 Nc Hwy 65, Wentworth, NC 27375 | 2014-12-02 |
| 1790192748 | Bobbie Jo Harris | Registered Nurse | 405 Nc Hwy 65, Wentworth, NC 27375 | 2014-07-22 |
| 1275965089 | Christopher Revelle | Counselor | 405 Nc Hwy 65, Wentworth, NC 27375 | 2013-08-02 |
| 1528402047 | Brittney Sherrill | Counselor | 405 Nc Hwy 65, Wentworth, NC 27375 | 2013-04-26 |
| 1386984532 | Tonya Butcher | Registered Nurse | 405 Nc Hwy 65, Wentworth, NC 27375 | 2013-02-26 |
| 1912075870 | Carl Raymond Britton Watkins | Counselor | 405 Nc 65, Wentworth, NC 27375 | 2006-11-30 |
| Find all providers in zip 27375 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403884 | Billy Scott II | Physician Assistant | 3000 Rogers Rd Ste 100, Wake Forest, NC 27587-5745 | 2020-10-05 |
| 1982213765 | Michaela Lynne Mcbride | Physician Assistant | 9541 Kings Parade Blvd Unit 107, Charlotte, NC 28273-5819 | 2020-07-28 |
| 1386260347 | Elizabeth Warrington Maiche | Physician Assistant | 113 Montgomery Dr, Saluda, NC 28773-7787 | 2020-06-24 |
| 1831715663 | John Wheary | Physician Assistant | 3233 Austin Ave, New Bern, NC 28562-7084 | 2020-06-17 |
| 1629692439 | Julie Anne Augustine | Physician Assistant | 718 S Green St, Winston Salem, NC 27101-5112 | 2020-06-08 |
| 1659995710 | Kristopher Neal Priddy | Physician Assistant | 405 Forest Hill Dr, Shelby, NC 28150-5520 | 2020-06-04 |
| 1710500558 | Christian Wright Fulenwider | Physician Assistant | 104 Linden St, Morganton, NC 28655-3788 | 2020-05-27 |
| 1366065500 | Lisa Lynn Carder | Physician Assistant | 904 Foxcroft Cir Apt D, Shelby, NC 28152-6868 | 2020-05-22 |
| 1982234282 | Brandon Sorkin | Physician Assistant | 280 Executive Park Drive, Suite 100, Concord, NC 28025-2802 | 2020-01-25 |
| 1245860618 | Robert Maughan | Physician Assistant | 129 Bryce Creek Ln, Fayetteville, NC 28303-4981 | 2020-01-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.