NPIMap

Individual provider Active NPI

Jaclyn Bates

  • Physician Assistant
  • Rockingham, NC
National Provider Identifier
1184994238
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-03285 Issued in NC
Practice address
921 S Long Dr Ste 101
Rockingham, NC 28379-4874
Phone
(910) 417-3850
NPI assigned
Jan 6, 2012
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-03285 NC Primary

Addresses

Primary practice location

921 S Long Dr Ste 101
Rockingham, NC 28379-4874

Mailing address

921 S Long Dr Ste 101
Rockingham, NC 28379-4874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120228000254 NC Practitioner - Physician Assistant 2062670680 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FHPG LLCGroup PAC ID 9537481569, 195 clinicians

Practice addresses (Care Compare)

7473-B Hwy 22
Whispering Pines, NC 28327
Phone (910) 215-5115

921 S Long Dr
Suite 101
Rockingham, NC 28379-4874
Phone (910) 417-3850

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.84 of 100Reported as group
Quality
79.14
Promoting interoperability
92
Improvement activities
40
Cost
80.32

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
FHPG, LLC CurrentSince Mar 25, 2021 Accepting new patients
FHPG, LLC Past Accepting new patients
FHPG, LLC Past Accepting new patients

Locations

921 S Long Dr
Ste 101
Rockingham, NC 28379
Phone (910) 417-3850

Organizations & group practices 5

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": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1184994238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 S LONG DR STE 101",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283794874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 S LONG DR STE 101",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283794874",
            "telephone_number": "910-417-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "JACLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockingham, NC

Sources for this page

Verify at the official NPI Registry.