Individual provider Active NPI

Jennifer Susanne Harvey, MD

  • Family Medicine Physician
  • Kernersville, NC
National Provider Identifier
1184011843
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019-00780 Issued in NC
Practice address
1730 Kernersville Medical Pkwy Ste 204
Kernersville, NC 27284-7198
Phone
(336) 277-4460
Fax
(336) 992-2674
NPI assigned
Apr 21, 2015
Last updated
Oct 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NC
Family Medicine Physician 207Q00000X 2019-00780 NC Primary

Addresses

Primary practice location

1730 Kernersville Medical Pkwy Ste 204
Kernersville, NC 27284-7198

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jharvey247469@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190926000754 NC Practitioner - Family Practice 9335457274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1730 Kernersville Medical Pkwy
Suite 204
Kernersville, NC 27284-7198
Phone (336) 277-4460

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019-00780NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Medical Group, Inc CurrentSince Aug 12, 2019 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 12, 2019 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

4741 Randolph Rd
#100
Charlotte, NC 28211
Phone (704) 365-6730

7210 Village Medical Cir
Ste 110
Clemmons, NC 27012
Phone (336) 893-2400

1622 Highwoods Blvd
Unit G105
Greensboro, NC 27410
Phone (336) 277-4460

1300 N University Pkwy
High Point, NC 27262
Phone (336) 841-4683

6431 Old Plank Rd
High Point, NC 27265
Phone (336) 875-6530

1730 Kernersville Medical Pkwy
Ste 204
Kernersville, NC 27284
Phone (336) 277-4460

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

211 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-1191

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: jharvey247469@direct.novanthealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1184011843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 KERNERSVILLE MEDICAL PKWY STE 204",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847198",
            "telephone_number": "336-277-4460",
            "fax_number": "336-992-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVEY",
        "first_name": "JENNIFER",
        "middle_name": "SUSANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-21",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2019-00780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jharvey247469@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1730 Kernersville Medical Pkwy Ste 204",
            "city": "Kernersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272847198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.