MEDICARE: RACHEL L ONDEK PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	085-005520	IL
2	363A00000X	Physician Assistant	085005520	IL
3	363A00000X	Physician Assistant	0010-10964	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0010-10964	OTHER	NC	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1003299637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL L ONDEK PA-C

Provider Business Mailing Address
First Line	:	3714 GUARDIAN AVE STE E
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-2975
Country	:	US
Telephone Number	:	252-247-2101
Fax Number	:	252-247-4675

Provider Business Practice Location Address
First Line	:	2145 COUNTRY CLUB RD STE 800
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-2404
Country	:	US
Telephone Number	:	910-939-5759
Fax Number	:	910-939-4951

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2015
Last Update Date	:	02/09/2023

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Directions to “ RACHEL L ONDEK PA-C” Practice Location

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