Individual provider Active NPI

Brian Nicholas Jammel, PA-C

  • Physician Assistant
  • Mooresville, NC
National Provider Identifier
1063865525
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12951 Issued in NC
Practice address
295 Williamson Rd Ste 101
Mooresville, NC 28117-8268
Phone
(980) 444-2003
NPI assigned
Jul 20, 2016
Last updated
Mar 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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 0010-12951 NC Primary

Addresses

Primary practice location

295 Williamson Rd Ste 101
Mooresville, NC 28117-8268

Mailing address

1025 Peerless Xing NW
Cleveland, TN 37312-3764
Phone (423) 476-5990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161026002668 FL Practitioner - Physician Assistant 2163700105 Reassigns benefits to 2 organizations
I20230208000999 NC Practitioner - Physician Assistant 2163700105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Afc Urgent Care and Family Care of WNC PLLCGroup PAC ID 2567713332, 75 clinicians

Practice addresses (Care Compare)

10102 Johnston Rd
Charlotte, NC 28210-8203
Phone (704) 247-6578

14221 Boren St
Huntersville, NC 28078-6507
Phone (980) 306-5911

1908 E Franklin Blvd
Suite 100
Gastonia, NC 28054-4742
Phone (704) 271-1215

210 Turnersburg Hwy
Suite C
Statesville, NC 28625-2797
Phone (704) 924-4740

295 Williamson Rd
Suite a
Mooresville, NC 28117-8269
Phone (980) 444-2003

955 2ND St NE
Hickory, NC 28601-3840
Phone (423) 476-5990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Observation Medicine Specialists LLC Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1063865525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 PEERLESS XING NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123764",
            "telephone_number": "423-476-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 WILLIAMSON RD STE 101",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178268",
            "telephone_number": "980-444-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMMEL",
        "first_name": "BRIAN",
        "middle_name": "NICHOLAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-20",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.