Individual provider Active NPI

Jeffery Justin Kern, PA-C

  • Medical Physician Assistant
  • Rockingham, NC
National Provider Identifier
1194713701
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
103521 Issued in NC
Practice address
104 Physicians Park Dr
Rockingham, NC 28379-5204
Phone
(910) 895-1989
Fax
(910) 895-9666
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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 103521 NC Primary

Addresses

Primary practice location

104 Physicians Park Dr
Rockingham, NC 28379-5204

Mailing address

PO Box 843013
Boston, MA 02284-3013
Phone (910) 895-1989

Other identifiers 1

IdentifierTypeStateIssuer
103521OtherNCSTATE LICENSE

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
I20080506000071 NC Practitioner - Physician Assistant 3678652484 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FHPG LLCGroup PAC ID 9537481569, 195 clinicians

Practice addresses (Care Compare)

104 Physicians Park Dr
Rockingham, NC 28379-5204
Phone (910) 895-1989

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

Hospital & facility affiliations

  • Firsthealth Moore Regional Hospital Hospital, Pinehurst, NC, CCN 340115

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

State licenses

LicenseStateTypeSpecialty
103521NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MCPC-8, LLC Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
MCPC-8, LLC Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
FHPG, LLC Family Medicine CurrentSince Oct 1, 2014 Accepting new patients
FHPG, LLC Family Medicine CurrentSince Oct 1, 2014 Accepting new patients

Locations

208 W Salisbury St
Ste A
Asheboro, NC 27203
Phone (336) 523-0040

1021 W Hamlet Ave
Hamlet, NC 28345
Phone (910) 417-4100

150 Ivey Ln
Ste A
Pinehurst, NC 28374
Phone (910) 215-5200

46 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-6782

4565 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-5100

313 Teal Dr
Raeford, NC 28376
Phone (910) 904-2350

104 Physicians Park Dr
Rockingham, NC 28379
Phone (910) 895-1989

1602 Westover Dr
Sanford, NC 27330
Phone (919) 897-2250

7473 NC 22 Hwy
Whispering Pines, NC 28327
Phone (910) 215-5100

Interoperability endpoints

  • Direct secure messaging: jkern17419@firsthealth.direct-ci.net

Organizations & group practices 7

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 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": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1194713701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843013",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022843013",
            "telephone_number": "910-895-1989",
            "fax_number": "910-895-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 PHYSICIANS PARK DR",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283795204",
            "telephone_number": "910-895-1989",
            "fax_number": "910-895-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERN",
        "first_name": "JEFFERY",
        "middle_name": "JUSTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "103521",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockingham, NC

Sources for this page

Verify at the official NPI Registry.