Individual provider Active NPI

Jennifer Frances Nusbaum, PA-C

  • Physician Assistant
  • Chapel Hill, NC
National Provider Identifier
1073365284
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001014128 Issued in NC
Practice address
101 Manning Dr
Chapel Hill, NC 27514-4220
Phone
(984) 974-1315
NPI assigned
Apr 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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 001014128 NC Primary

Addresses

Primary practice location

101 Manning Dr
Chapel Hill, NC 27514-4220

Mailing address

104 Bergeron Way
Cary, NC 27519-6669

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jnusbaum1176194@direct.UNC.nchie.net Direct
Direct Messaging Address jnusbaum1176194@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240927000035 NC Practitioner - Physician Assistant 9739610064 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Tennessee, HSC, College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Eastowne Dr
Chapel Hill, NC 27514-2286
Phone (984) 215-5556

101 Manning Dr
Chapel Hill, NC 27514-4220

102 Mason Farm Rd
Chapel Hill, NC 27514-4617

430 Waterstone Dr
Hillsborough, NC 27278-9078
Phone (984) 215-2000

460 Waterstone Dr
Hillsborough, NC 27278-9078
Phone (984) 215-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001014128NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Jul 8, 2024 Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Jul 8, 2024 Accepting new patients
University of North Carolina Hospitals at Chapel Hill PastSince Apr 1, 2024 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

102 Mason Farm Rd
Chapel Hill, NC 27514
Phone (919) 966-1459

101 Manning Dr
Bldg 2
Chapel Hill, NC 27514
Phone (919) 843-8741

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

100 Eastowne Dr
Fl 14
Chapel Hill, NC 27514
Phone (984) 215-5556

460 Waterstone Dr
Hillsborough, NC 27278
Phone (984) 215-2444

430 Waterstone Dr
Hillsborough, NC 27278
Phone (984) 215-2000

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

75 Freedom Pkwy
Ste D
Pittsboro, NC 27312
Phone (984) 215-3220

475 Progress Blvd
Siler City, NC 27344
Phone (919) 799-4000

163 Medical Park Dr
#110
Siler City, NC 27344
Phone (919) 799-4015

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1073365284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BERGERON WAY",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275196669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "984-974-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSBAUM",
        "first_name": "JENNIFER",
        "middle_name": "FRANCES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-02",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001014128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jnusbaum1176194@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jnusbaum1176194@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDD/CDA/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.