Jacquelyn Diane Visser, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-08997 Issued in NC

Practice address

1236 Huffman Mill Rd Ste 130
Burlington, NC 27215-8700

Phone

(336) 438-1060

NPI assigned

Apr 3, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jacquelyn Diane Connell Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jvisser483700@direct.conehealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of North Carolina at Chapel Hill

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200
  Medicare reassignment Care Compare group NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1013265909
  Medicare reassignment NPD
• Moses Cone Affiliated Physicians, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Greensboro, NC
  • NPI 1952614620
  NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Community/Retail Pharmacy
  • Eden, NC
  • NPI 1861222507
  NPD
• Park Ophthalmology

  • Ophthalmology Physician
  • Durham, NC
  • NPI 1619150141
  NPD (past)
• University of North Carolina Hospitals at Chapel Hill

  • Pediatric Nutrition Registered Dietitian
  • Chapel Hill, NC
  • NPI 1861415804
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of North Carolina Hospitals at Chapel Hill

  • General Acute Care Hospital
  • Chapel Hill, NC
  • NPI 1932208576
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1023570538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2087 CAMPUS BOX",
            "city": "ELON",
            "state": "NC",
            "postal_code": "272442010",
            "telephone_number": "336-278-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 HUFFMAN MILL RD STE 130",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158700",
            "telephone_number": "336-438-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISSER",
        "first_name": "JACQUELYN",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvisser483700@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "cone health direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1236 Huffman Mill Rd Ste 130",
            "city": "Burlington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272158700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "CONNELL",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Burlington, NC
• Providers in Burlington, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.