Individual provider Active NPI

Jennifer E Mixter, P.A.

  • Medical Physician Assistant
  • Charlotte, NC
National Provider Identifier
1205268448
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-05528 Issued in NC
Practice address
501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211-0035
Phone
(704) 377-2424
Fax
(704) 377-2687
NPI assigned
Jul 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0005069 MD
Medical Physician Assistant 363AM0700X 0010-05528 NC Primary

Addresses

Primary practice location

501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211-0035

Mailing address

501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211-0035
Phone (704) 377-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131011000979 DC Practitioner - Physician Assistant 6709010473 Reassigns benefits to 2 organizations
I20150925002744 NC Practitioner - Physician Assistant 6709010473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.97 of 100Reported as group
Quality
79.68
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-05528NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Sep 1, 2013 Accepting new patients
Alexandria Springfield Emergency Physicians PC CurrentSince Sep 1, 2013 Accepting new patients
Alexandria Springfield Emergency Physicians PC CurrentSince Sep 1, 2013 Accepting new patients
Emergency Medicine Associates PA CurrentSince Sep 1, 2013 Accepting new patients
Mema SC LLC PastSince Oct 13, 2024 Accepting new patients

Locations

20010 Century Blvd
Ste 200
Germantown, MD 20874

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1205268448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S SHARON AMITY RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110035",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S SHARON AMITY RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110035",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIXTER",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0005069",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-05528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.