Jordan Andrew Shealy, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2021-02023 Issued in NC

Practice address

130 Glendale Dr W
Wilson, NC 27893-2770

Phone

(252) 399-7557

NPI assigned

Apr 12, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Medical University of South Carolina College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wilson Medical Center Hospital, Wilson, NC, CCN 340126
• Unc Health Nash Hospital, Rocky Mount, NC, CCN 340147

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshealy717042@direct.unc.nchie.net

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.

• Unc Physicians Network LLC

  • Family Medicine Physician
  • Pittsboro, NC
  • NPI 1750704367
  Medicare reassignment Care Compare group
• North Carolina MG, LLC

  • Hospitalist Physician
  • Raleigh, NC
  • NPI 1215741640

  Surgery

  NPD
• Unc Physicians Network LLC

  • General Practice Physician
  • Morrisville, NC
  • NPI 1558786830
  NPD
• Rex Hospital Inc

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1972939643
  NPD (past)

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

• DLP Wilson Medical Center LLC

  • General Acute Care Hospital
  • Wilson, NC
  • NPI 1215359922
  Care Compare affiliation
• DLP Wilson Medical Center LLC

  • Psychiatric Hospital Unit
  • Wilson, NC
  • NPI 1386196459
  Care Compare affiliation
• Nash Hospitals Inc

  • General Acute Care Hospital
  • Rocky Mount, NC
  • NPI 1619969219
  Care Compare affiliation

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1033573464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY # U-11",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-305-9230",
            "fax_number": "865-305-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 GLENDALE DR W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278932770",
            "telephone_number": "252-399-7557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1924 Alcoa Hwy # U-11",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379201511",
            "country_code": "US",
            "telephone_number": "865-305-9230",
            "fax_number": "865-305-8894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEALY",
        "first_name": "JORDAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-12",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2021-02023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshealy717042@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "130 Glendale Dr W",
            "city": "Wilson",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278932770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelly Anne Senglar-Vitale, PT, DPT, COMT, MDT
• Serenity of Wilson Home Care Inc.
• Lisa Butler Sewell, LCSW
• Barbara Sharp, LCSW-A
• She Soars LLC
• Tammy Winn Shealy, PHARMD
• Dorothy L Sherrod-Bynum, C.R.C., L.P.C.
• Heather Johnson Sherrod, PHARMD
• Tracey P Sherrod, ANP-C
• Shifa Medicine & Infectious Diseases

• Surgery Physician in Wilson, NC
• Providers in Wilson, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.