Individual provider Active NPI

Jasmine Ciera Bryant Skinner, MD

  • Family Medicine Physician
  • Wilson, NC
National Provider Identifier
1104454339
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2023-02419 Issued in NC
Practice address
3724 Raleigh Rd W
Wilson, NC 27896-9742
Phone
(252) 246-8840
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2023-02419 NC Primary

Addresses

Primary practice location

3724 Raleigh Rd W
Wilson, NC 27896-9742

Mailing address

3724 Raleigh Road Pkwy W
Wilson, NC 27896-9742

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230918002909 NC Practitioner - Family Practice 8628432051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

3724 Raleigh Rd Pkwy W
Wilson, NC 27896-9742
Phone (252) 246-8840

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Greenville, NC, CCN 347031
  • Wilson Medical Center Hospital, Wilson, NC, CCN 340126
  • Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Sep 5, 2023 Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

3724 Raleigh Road Pkwy W
Wilson, NC 27896
Phone (252) 246-8840

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1104454339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 RALEIGH ROAD PKWY W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278969742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 RALEIGH RD W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278969742",
            "telephone_number": "252-246-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "JASMINE",
        "middle_name": "CIERA BRYANT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-02419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

Verify at the official NPI Registry.