EDEN INTERNAL MEDICINE PLLC
NPI 1275773954
Physician Assistant in Eden, NC

Q: What is Eden Internal Medicine PLLC's NPI number?

The NPI number for Eden Internal Medicine PLLC is 1275773954. It was assigned to this organization in the NPPES registry on February 20, 2009.

Q: What is Eden Internal Medicine PLLC's specialty?

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

Active since February 20, 2009CLIA 34D0238368 · Waiver

405 THOMPSON ST, EDEN, NC 27288(336) 627-4896(336) 627-0139 Get Directions Write a Review

NPPES record last updated: February 20, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Eden Internal Medicine Pllc NPPES

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

EDEN INTERNAL MEDICINE PLLC (NPI 1275773954) is a healthcare organization registered as a physician assistant in Eden, North Carolina and active in the NPI registry since February 2009. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Angela Marie Raymer, Physician Assistant Certified, as its authorized official.

NPPES Registry Identity

NPI1275773954

Entity TypeOrganization

Primary Taxonomy363A00000X

Legal Business NameEDEN INTERNAL MEDICINE PLLC

Location Address405 THOMPSON STEden, NC 27288-5045

Mailing Address405 Thompson StEden, NC 27288-5045 · (336) 627-4896 · Fax (336) 627-0139

Phone(336) 627-4896

Fax(336) 627-0139

Organization SubpartNo

Authorized OfficialAngela Marie RaymerPhysician Assistant Certified · (336) 627-4896

Enumeration DateFebruary 20, 2009

✔ NPI 1275773954 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 · 0010-01723

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.

405 THOMPSON ST, Eden, NC 27288

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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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D0238368

Eden Internal Medicine PLLC · Eden, NC

Active · expires Aug 31, 2026

CLIA Number34D0238368

Laboratory TypePhysician Office

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorAshish C. Shah MD

Laboratory Phone(336) 627-4896

Laboratory LocationEden Internal Medicine PLLC405 Thompson Street, Eden, NC 27288

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KEAVIE C. HAIRFIELD MSN, FNP-C

Nurse Practitioner (Family)