Individual provider Active NPI

Jessica Renee Jones, PA

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1134465586
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-03956 Issued in NC
Practice address
3480 Wake Forest Rd
Suite 414
Raleigh, NC 27609-7376
Phone
(919) 862-5970
NPI assigned
Dec 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0010-03956 NC
Physician Assistant 363A00000X 0010-03956 NC Primary

Addresses

Primary practice location

3480 Wake Forest Rd
Suite 414
Raleigh, NC 27609-7376

Mailing address

3480 Wake Forest Rd
Suite 414
Raleigh, NC 27609-7376

Other practice location 1

107 W Hargett St Ste 110
Raleigh, NC 27601-1760
Phone (984) 255-2107

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
I20130225000237 NC Practitioner - Physician Assistant 2860647815 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preston Dermatology and Skin Surgery Center PAGroup PAC ID 0547533291, 9 clinicians
Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

1010 High House Rd
Suite 300
Cary, NC 27513-3581
Phone (919) 889-8829

3420 Ten Ten Rd
Suite 318
Cary, NC 27518-6101
Phone (919) 362-5871

6500 Creedmoor Rd
Suite 110
Raleigh, NC 27613-3698
Phone (919) 825-4000

7010 NC Hwy 751
Durham, NC 27707-5733
Phone (919) 313-3900

Hospital & facility affiliations

  • Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040

Merit-based Incentive Payment System (MIPS)

Final score
74.09 of 100Reported as group
Quality
65.78
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-03956NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fastmed Primary Care, P.C. Past Accepting new patients
Dermone of North Carolina PA PastSince Jan 1, 2018 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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1355270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1134465586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 WAKE FOREST RD",
            "address_2": "SUITE 414",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 WAKE FOREST RD",
            "address_2": "SUITE 414",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097376",
            "telephone_number": "919-862-5970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 W Hargett St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276011760",
            "country_code": "US",
            "telephone_number": "984-255-2107",
            "fax_number": "919-831-1183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-12",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-03956",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.