Provider Demographics
NPI:1699877340
Name:HOPKINS, MICHELLE SIMMONS (PA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:SIMMONS
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:332 N TRADE ST
Practice Address - Street 2:STE 1100
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-1728
Practice Address - Country:US
Practice Address - Phone:704-512-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00605363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0542PAMedicaid
NC1699877340Medicaid
NC8101200Medicaid
NCNC1873GMedicare UPIN
NCQ74015Medicare UPIN
NCNC1873FMedicare UPIN
NCNC1873HMedicare UPIN
NC8101200Medicaid
SCAA92367772Medicare PIN
NCNC1873QMedicare UPIN
NCNC1873JMedicare UPIN
NCNC1873RMedicare UPIN
NCNC1873PMedicare UPIN
NCNC1873NMedicare UPIN
NC1699877340Medicaid
NCNC1873IMedicare UPIN
NCNC1873CMedicare UPIN
NCNC1873EMedicare UPIN
NCNC1873KMedicare UPIN
NCNC1873LMedicare UPIN
NCNC1873MMedicare UPIN
NCNC1873PMedicare PIN