Individual provider Active NPI

Virginia Ann Jethro, PA-C

  • Medical Physician Assistant
  • Raleigh, NC
National Provider Identifier
1114988292
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
103811 Issued in NC
Practice address
1540 Sunday Dr
Raleigh, NC 27607-6010
Phone
(919) 782-3456
Fax
(919) 783-1441
NPI assigned
Mar 29, 2006
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103811 NC
Medical Physician Assistant 363AM0700X 103811 NC Primary
Medical Physician Assistant 363AM0700X MA-052635 PA

Addresses

Primary practice location

1540 Sunday Dr
Raleigh, NC 27607-6010

Mailing address

1540 Sunday Dr
Raleigh, NC 27607-6010
Phone (919) 782-3456

Other practice location 1

1520 Sunday Dr
Raleigh, NC 27607-5253
Phone (919) 782-3456

Other names 1

  • Virginia Ann Burke Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vjethro@rna.medalliesdirect.net Health Information Exchange (HIE)

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
I20140111000150 NC Practitioner - Physician Assistant 1759450901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1540 Sunday Dr
Raleigh, NC 27607-6010

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85 of 100Reported as group
Quality
65.93
Promoting interoperability
100
Improvement activities
40
Cost
84.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA-052635PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Neurology PLLC PastSince Nov 13, 2006 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: virginia.jethro.1@25810.direct.athenahealth.com

Organizations & group practices 2

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 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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1114988292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 SUNDAY DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076010",
            "telephone_number": "919-782-3456",
            "fax_number": "919-783-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 SUNDAY DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076010",
            "telephone_number": "919-782-3456",
            "fax_number": "919-783-1441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 Sunday Dr",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276075253",
            "country_code": "US",
            "telephone_number": "919-782-3456",
            "fax_number": "919-783-1441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JETHRO",
        "first_name": "VIRGINIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103811",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103811",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA-052635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vjethro@rna.medalliesdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1520 Sunday Dr",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276075253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "BURKE",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.