Individual provider Active NPI

Jawanza Nyahuma Jabari, M.D.

  • Anesthesiology Physician
  • Whiteville, NC
National Provider Identifier
1144294943
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2020-03599 Issued in NC
Practice address
500 Jefferson St
Whiteville, NC 28472-3634
Phone
(910) 642-8011
NPI assigned
Feb 16, 2006
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2020-03599 NC Primary
Anesthesiology Physician 207L00000X 228274 NY

Addresses

Primary practice location

500 Jefferson St
Whiteville, NC 28472-3634

Mailing address

1305 Walt Whitman Rd Ste 300
Melville, NY 11747-4300
Phone (866) 306-6007

Other identifiers 2

IdentifierTypeStateIssuer
1144294943MedicaidNC
257014900MedicaidFL

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
I20201026002136 NC Practitioner - Anesthesiology 1557338365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio State University College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Jefferson St
Whiteville, NC 28472-3634
Phone (910) 642-8011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020-03599NCMDAnesthesiology Physician
228274NYMDAnesthesiology Physician
TP394KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Anesthesiology Consultants, PLLC Anesthesiology CurrentSince Aug 1, 2020 Accepting new patients
Southeast Anesthesiology Consultants, PLLC Anesthesiology CurrentSince Aug 1, 2020 Accepting new patients
Lake County Anesthesia Associates PA Past Accepting new patients
North Pinellas Anesthesia Associates, PA Anesthesiology PastSince May 7, 2023 Accepting new patients
Bradenton Anesthesia Services LLC Anesthesiology Past Accepting new patients
Appalachian Regional Healthcare, Inc. Past Accepting new patients
Outpatient Anesthesia of Southwest Florida Inc PastSince Jan 1, 2013 Accepting new patients
The Stingl Family Foundation, Inc PastSince May 7, 2016 Accepting new patients
Anesthesia & Pain Consultants of SW FL PastSince Jan 1, 2019 Accepting new patients
Brevard Anesthesia Services PA Anesthesiology PastSince Dec 1, 1999 Accepting new patients
Sebring Pain Management & Rehabilitation Center LLC Past Accepting new patients
The Anesthesia Group, P.a. Anesthesiology Past Accepting new patients
Allmed Anesthesia Associates, LLC Past Accepting new patients

Locations

16455 Statesville Rd
Huntersville, NC 28078
Phone (704) 801-3719

500 Jefferson St
Whiteville, NC 28472
Phone (910) 642-1776

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Interoperability endpoints

  • Direct secure messaging: jjabari@crhn.cernerdirect.com

Organizations & group practices 13

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.

View all 13

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1144294943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 WALT WHITMAN RD STE 300",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474300",
            "telephone_number": "866-306-6007",
            "fax_number": "704-248-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723634",
            "telephone_number": "910-642-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABARI",
        "first_name": "JAWANZA",
        "middle_name": "NYAHUMA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2020-03599",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "228274",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144294943",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257014900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

Verify at the official NPI Registry.