Individual provider Active NPI

Jennifer Beacham Person, PA-C

  • Physician Assistant
  • Greenville, NC
National Provider Identifier
1215117122
Registry record updated Oct 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01128 Issued in NC
Practice address
202 E Arlington Blvd Ste a
Greenville, NC 27858-5021
Phone
(910) 376-0225
NPI assigned
Nov 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2025

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 0010-01128 NC Primary

Addresses

Primary practice location

202 E Arlington Blvd Ste a
Greenville, NC 27858-5021

Mailing address

PO Box 1139
Kenai, AK 99611-1139
Phone (910) 376-0225

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
I20100430000167 NC Practitioner - Physician Assistant 8820125495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
74.09 of 100Reported as group
Quality
65.78
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-01128NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Red Phoenix & Co. Current Accepting new patients
Down East Family Medicine, PLLC CurrentSince Nov 8, 2010 Accepting new patients
Fastmed Primary Care, P.C. PastSince Dec 10, 2023 Accepting new patients
Suncoast Medical, PC Past Accepting new patients
Buglisi Eye Care, PLLC PastSince Mar 28, 2012 Accepting new patients

Locations

306 Brynn Marr Rd
Jacksonville, NC 28546
Phone (910) 353-1276

Organizations & group practices 6

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": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759536000000",
    "number": "1215117122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1139",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996111139",
            "telephone_number": "910-376-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E ARLINGTON BLVD STE A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585021",
            "telephone_number": "910-376-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSON",
        "first_name": "JENNIFER",
        "middle_name": "BEACHAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2025-10-04",
        "certification_date": "2025-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.