Individual provider Active NPI

Jenna Santiago-Wickey, DO

  • Emergency Medicine Physician
  • Lumberton, NC
National Provider Identifier
1265880124
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
219288 Issued in NC
Practice address
300 W 27TH St
Lumberton, NC 28358-3075
Phone
(910) 272-1478
Fax
(910) 671-5392
NPI assigned
Jun 1, 2016
Last updated
Jun 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 219288 NC Primary

Addresses

Primary practice location

300 W 27TH St
Lumberton, NC 28358-3075

Mailing address

300 W 27TH St
Lumberton, NC 28358-3075
Phone (910) 272-1478

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200615003319 NC Practitioner - Emergency Medicine 3173816162 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians

Practice addresses (Care Compare)

557 Brookdale Dr
Statesville, NC 28677-4107
Phone (336) 716-2255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as group
Quality
84.49
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
85.58
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.02 of 100Reported as group
Quality
82.48
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
219288NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Thomasville Medical Center, LLC CurrentSince Oct 11, 2022 Accepting new patients
Tanglewood Park Physicians, PLLC Emergency Medicine CurrentSince May 15, 2020 Accepting new patients
Piedmont Triad Physicians, PLLC Emergency Medicine CurrentSince May 15, 2020 Accepting new patients
Wake Forest Emergency Providers CurrentSince Jan 3, 2023 Accepting new patients
Novant Health Thomasville Medical Center LLC CurrentSince Oct 11, 2022 Accepting new patients
Kernersville Emergency Group, PLLC Emergency Medicine CurrentSince May 15, 2020 Accepting new patients
Robeson Emergency Physicians, PLLC Emergency Medicine CurrentSince Apr 15, 2020 Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: jsantiagowickey2881095@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: jsantiagowickey813513@direct.unc.nchie.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1265880124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583075",
            "telephone_number": "910-272-1478",
            "fax_number": "910-671-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583075",
            "telephone_number": "910-272-1478",
            "fax_number": "910-671-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO-WICKEY",
        "first_name": "JENNA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "219288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.