2020-00357
Active
No
02/25/2020
11/23/2026
Active Supervisees
| Name | Type | Status | Approved | Inactive |
|
Barber, Tiffany Joy
| Nurse Practitioner |
Active
|
09/30/2024
|
|
|
Davis, William Simpson
| Physician Assistant |
Active
|
12/05/2024
|
|
|
Fernandez Vazquez, Ruben
| Physician Assistant |
Active
|
07/14/2025
|
|
|
Filla, Wynonah Lyn
| Physician Assistant |
Active
|
09/03/2025
|
|
|
Fogel, Michael Paul
| Physician Assistant |
Active
|
04/10/2024
|
|
|
Hilton, Coltyn
| Nurse Practitioner |
Active
|
11/20/2024
|
|
|
Kaczmarczyk, Marzena
| Physician Assistant |
Active
|
12/28/2023
|
|
|
Miley, Kathryn Lynn
| Nurse Practitioner |
Active
|
02/06/2024
|
|
|
Pace, Matthew Tyler
| Physician Assistant |
Active
|
02/21/2025
|
|
|
Rapp, Kevin Austin
| Physician Assistant |
Active
|
04/10/2024
|
|
|
Smith, Charlotte Renee
| Physician Assistant |
Active
|
03/21/2024
|
|
North Carolina Hospital Admitting Privileges
| Location |
| Wilson Medical Center |
Out of State Active/Inactive Licenses
Out of Country Active/Inactive Licenses
Address
Wilson Medical Center
1705 Tarboro St
Wilson, NC 27893
252-399-8040
Information
Medical School
| School | Graduation |
| Cornell University Medical College | 2015 |
Post Graduate Training
"Last Year" does not necessarily mean that the licensee completed his/her training program. (In NC, a physician can be licensed without completing such a program.)
| Institution | Specialty | State, Country | Training Program | Last Year |
| Beth Israel Deaconess Medical Center | Emergency Medicine |
MA, US
| Residency | 2018 |
| Beth Israel Deaconess Medical Center | Emergency Medicine |
MA, US
| Internship | 2016 |
Current Board Certification and Year of Certification/Recertification
Physicians should not list non-ABMS or non-AOA specialty boards unless the board meets the criteria set forth in the NC Medical Board’s Advertising and Publicity Position Statement.
| Primary/Subspecialty | Year |
| Emergency Medicine | 2019 |
Area of Practice
| Area Of Practice | Primary |
| Emergency Medicine | Yes |
Current Membership in Medical Professional Organizations
Honors & Awards
| Honor/Award | Given By | Date |
| None Reported |
Public Service
| Name of Clinic | Service Description | Date |
| None Reported |
Current Academic Appointments
| Title | Institution | City, State, Country |
| None Reported |
Publications
Section 1: Adverse Actions
North Carolina Medical Board Public Actions
| Date | Description | Link |
| None Reported |
Other Regulatory Board or Agency Public Actions
| Date | Name of Board/Agency | Action Taken | Link |
| None Reported |
Health Care Institution Suspensions and Revocations
| Date | Health Care Institution | Action Taken |
| None Reported |
Section 2: Administrative Actions
Actions listed in this section are considered non-disciplinary by the Board. In situations where
administrative actions are taken, the licensee may not have met certain statutory requirements or
may have failed to follow correct administrative procedures.
North Carolina Medical Board Reentry Agreement
| Date | Description | Link |
| None Reported |
North Carolina Special Purpose Licensing Agreement
| Date | Description | Link |
| None Reported |
Malpractice Information
The Board is currently reviewing the care that led to this payment.
| Incident Date | Payment Date | Area of Practice | City, State, Country | Response |
| None Reported |
Misdemeanor/DUI/DWI Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |
Felony Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |