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CLEAR WATER MEDICAL LLC
NPI 1043512783
Physician Assistant in Wilmington, NC

Active since December 01, 2010
4912 LAKE RENAISSANCE CIR, WILMINGTON, NC 28409(910) 465-2783(910) 794-4531 Get Directions Write a Review

NPPES record last updated: December 1, 2010. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Clear Water Medical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLEAR WATER MEDICAL LLC (NPI 1043512783) is a healthcare organization registered as a physician assistant in Wilmington, North Carolina and active in the NPI registry since December 2010. The organization lists William Anthony Gore, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1043512783
Entity TypeOrganization
Primary Taxonomy363A00000X
Legal Business NameCLEAR WATER MEDICAL LLC
Location Address4912 LAKE RENAISSANCE CIRWilmington, NC 28409-3303
Mailing AddressPo Box 16310Wilmington, NC 28408-6310 · (910) 465-2783 · Fax (910) 794-4531
Phone(910) 465-2783
Fax(910) 794-4531
Organization SubpartNo
Authorized OfficialWilliam Anthony GoreManaging Member · (910) 465-2783
Enumeration DateDecember 1, 2010
✔ NPI 1043512783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NC · 101955
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4912 LAKE RENAISSANCE CIR, Wilmington, NC 28409
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clear Water Medical LLC's NPI number?

The NPI number for Clear Water Medical LLC is 1043512783. It was assigned to this organization in the NPPES registry on December 1, 2010.

Where is Clear Water Medical LLC located?

Clear Water Medical LLC is located at 4912 Lake Renaissance Cir, Wilmington, NC 28409. The listed phone number is (910) 465-2783.

What is Clear Water Medical LLC's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Clear Water Medical LLC was last updated on December 1, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.