Individual provider Active NPI

Jesse Wakefield Sharp, PA-C

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1164091807
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10003372A Issued in IN
Practice address
521 S Bradford St
Baltimore, MD 21224-3605
Phone
(585) 694-4786
NPI assigned
Jun 17, 2021
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10003372A IN Primary

Addresses

Primary practice location

521 S Bradford St
Baltimore, MD 21224-3605

Mailing address

521 S Bradford St
Baltimore, MD 21224-3605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210909000620 IN Practitioner - Physician Assistant 2062818586 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ies HSP Indiana LLCGroup PAC ID 4486189040, 25 clinicians
St Francis Medical Group LLCGroup PAC ID 7012067697, 113 clinicians

Practice addresses (Care Compare)

1125 W Jefferson St
Franklin, IN 46131-2140
Phone (317) 736-3300

701 E County Line Rd
Suite 101
Greenwood, IN 46143-1070
Phone (317) 885-2860

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10003372AINMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Memorial Hospital CurrentSince Sep 2, 2021 Accepting new patients
St Francis Medical Group LLC CurrentSince Nov 11, 2024 Accepting new patients
Johnson Memorial Hospital CurrentSince Sep 2, 2021 Accepting new patients

Locations

1125 W Jefferson St
Franklin, IN 46131
Phone (317) 346-3858

701 E County Line Rd
Ste 101
Greenwood, IN 46143
Phone (317) 885-2860

355 Westfield Rd
Ste 114
Noblesville, IN 46060
Phone (317) 770-2937

Organizations & group practices 6

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 4

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": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1164091807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 S BRADFORD ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 S BRADFORD ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243605",
            "telephone_number": "585-694-4786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "JESSE",
        "middle_name": "WAKEFIELD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-17",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10003372A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.