Individual provider Active NPI

Jason Kyle Honaker, PA

  • Physician Assistant
  • Wake Forest, NC
National Provider Identifier
1215067541
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05410 Issued in NC
Practice address
10500 Ligon Mill Rd Ste 113
Wake Forest, NC 27587-4576
Phone
(919) 570-5705
NPI assigned
Mar 6, 2007
Last updated
Jul 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-05410 NC Primary
Physician Assistant 363A00000X 0110002364 VA
Physician Assistant 363A00000X 014724 NY

Addresses

Primary practice location

10500 Ligon Mill Rd Ste 113
Wake Forest, NC 27587-4576

Mailing address

PO Box 60447
Suite 4K
Charlotte, NC 28260-0447
Phone (910) 721-4100

Other practice location 1

584 Hospital Dr NE
Suite C
Bolivia, NC 28422-0019
Phone (910) 721-4100

Other practice location 2

257 Hospital Dr.
Suite 101
Bolivia, NC 28422-8411
Phone (910) 721-4100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jhonaker294786@direct.novanthealth.org

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
I20160401000452 NC Practitioner - Physician Assistant 6103123310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

10500 Ligon Mill Rd
Suite 113
Wake Forest, NC 27587-4576
Phone (919) 570-5705

257 Hospiatl Dr NE
Suite 100
Bolivia, NC 28422-8411
Phone (910) 721-4150

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

5145 Sellers Rd
Shallotte, NC 28470-3405
Phone (910) 754-4572

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-05410NCMDPhysician Assistant
014724NYMDPhysician Assistant
0110002364VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Feb 6, 2016 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Organizations & group practices 3

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 3

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1215067541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "address_2": "SUITE 4K",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "910-721-4100",
            "fax_number": "910-721-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 LIGON MILL RD STE 113",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874576",
            "telephone_number": "919-570-5705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "584 Hospital Dr NE",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Bolivia",
            "state": "NC",
            "postal_code": "284220019",
            "country_code": "US",
            "telephone_number": "910-721-4100",
            "fax_number": "910-721-4101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "257 Hospital Dr.",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Bolivia",
            "state": "NC",
            "postal_code": "284228411",
            "country_code": "US",
            "telephone_number": "910-721-4100",
            "fax_number": "910-721-4101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HONAKER",
        "first_name": "JASON",
        "middle_name": "KYLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05410",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002364",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhonaker294786@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "584 Hospital Dr NE",
            "address_2": "Suite C",
            "city": "Bolivia",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284220019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

Verify at the official NPI Registry.