Mr Derek Kelly Coburn, PA is a medicare enrolled "Physician Assistant" physician in Charlotte, North Carolina. He graduated from medical school in 2015 and has 9 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Carolinas Physicians Network Inc, Carolinas Physicians Network Inc and his current practice location is
2001 Vail Ave, Charlotte, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(208) 863-8974.
Mr Derek Kelly Coburn is licensed to practice in North Carolina (license number 0010-06199) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1861851784.
Physician's Profile
| Full Name | Mr Derek Kelly Coburn |
|---|
| Gender | Male |
|---|
| Speciality | Physician Assistant |
|---|
| Experience | 9 Years |
|---|
| Location | 2001 Vail Ave, Charlotte, North Carolina |
|---|
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Mr Derek Kelly Coburn graduated from medical school in 2015
NPI Data:
- NPI Number: 1861851784
- Provider Enumeration Date: 02/19/2016
- Last Update Date: 06/10/2020
Medicare PECOS Information:
- PECOS PAC ID: 0840589438
- Enrollment ID: I20160520001862
Medical Identifiers
Medical identifiers for Mr Derek Kelly Coburn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861851784 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 001006199 (North Carolina) | Secondary |
| 363A00000X | Physician Assistant | 0010-06199 (North Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Carolinas Physicians Network Inc | 3375449655 | 1649 |
| Carolinas Physicians Network Inc | 3375449655 | 1649 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Derek Kelly Coburn is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Derek Kelly Coburn, PA
3740 Wendwood Ln Apt 108,
Charlotte, NC 28211-1257
Ph: (208) 863-8974 | Mr Derek Kelly Coburn, PA
2001 Vail Ave,
Charlotte, NC 28207-1248
Ph: (208) 863-8974 |
Reviews and Comments