Individual provider Active NPI

Jennifer Vinez Slagle, PA-C

  • Physician Assistant
  • Boone, NC
National Provider Identifier
1063632503
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001000814 Issued in NC
Practice address
579 Greenway Rd.
Suite 200
Boone, NC 28607-4809
Phone
(828) 262-0100
Fax
(828) 264-7592
NPI assigned
Apr 26, 2007
Last updated
Aug 26, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001000814 NC Primary

Addresses

Primary practice location

579 Greenway Rd.
Suite 200
Boone, NC 28607-4809

Mailing address

579 Greenway Rd.
Suite 200
Boone, NC 28607-4809
Phone (828) 262-0100

Other names 1

  • Jennifer Elizabeth Vinez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001000814NCMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1063632503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 GREENWAY RD.",
            "address_2": "SUITE 200",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074809",
            "telephone_number": "828-262-0100",
            "fax_number": "828-264-7592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 GREENWAY RD.",
            "address_2": "SUITE 200",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074809",
            "telephone_number": "828-262-0100",
            "fax_number": "828-264-7592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAGLE",
        "first_name": "JENNIFER",
        "middle_name": "VINEZ",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001000814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "VINEZ",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.