Jerry Wayne Iery, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA983 Issued in KY

Practice address

142 Depot Dr
South Shore, KY 41175

Phone

(606) 932-2271

Fax

(606) 932-2273

NPI assigned

Oct 26, 2006

Last updated

Apr 18, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lewis County Primary Care Center, IncGroup PAC ID 1153311774, 86 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jerry.iery.1@13661.direct.athenahealth.com

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.

• Lewis County Primary Care Center, Inc.

  dba PrimaryPlus

  • Federally Qualified Health Center (FQHC)
  • Vanceburg, KY
  • NPI 1457303802
  Medicare reassignment Care Compare group NPD
• Lewis County Primary Care Center, Inc.

  dba PrimaryPlus - Morehead

  • Federally Qualified Health Center (FQHC)
  • Morehead, KY
  • NPI 1215643440
  NPD

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1255416384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "VANCEBURG",
            "state": "KY",
            "postal_code": "41179",
            "telephone_number": "606-796-3029",
            "fax_number": "606-796-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 DEPOT DR",
            "city": "SOUTH SHORE",
            "state": "KY",
            "postal_code": "41175",
            "telephone_number": "606-932-2271",
            "fax_number": "606-932-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IERY",
        "first_name": "JERRY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA983",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "1074488",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100017560",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100373870",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1074488",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Hardy-Garcia, LPCC
• Heart EMS Inc
• Gregory Hudson, MD
• Matthew G Hudson, MD
• Samuel David Hudson, MD
• Joseph Dental of South Shore LLC (South Shore Family Dental)
• Lewis County Primary Care Center, Inc. (South Shore Family Health Center Pharmacy)
• Lewis County Primary Care Center, Inc. (PrimaryPlus)
• Little Leaps Therapy Co.
• McDonald Pharmacy Inc (McDonald Pharmacy)

• Medical Physician Assistant in South Shore, KY
• Providers in South Shore, KY by specialty
• Medical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.