Individual provider Active NPI

Lindsay Yvonne Jenkins, PA-C

  • Physician Assistant
  • Greenville, NC
National Provider Identifier
1306117718
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-03329 Issued in NC
Practice address
101 Heart Drive
Ecu Physicians Family Medicine
Greenville, NC 27834-8944
Phone
(252) 744-4611
Fax
(252) 744-3201
NPI assigned
Jan 17, 2012
Last updated
Aug 1, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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 0010-03329 NC Primary

Addresses

Primary practice location

101 Heart Drive
Ecu Physicians Family Medicine
Greenville, NC 27834-8944

Mailing address

PO Box 751069
Charlotte, NC 28275-1069

Other names 1

  • Lindsay Yvonne Stagner Former name

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
I20120302000658 NC Practitioner - Physician Assistant 3476712852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

1202 Brown St
Washington, NC 27889-4671
Phone (252) 946-0136

1204 Brown St
Washington, NC 27889-4671
Phone (252) 946-6546

1209 Brown St
Washington, NC 27889-4671
Phone (252) 975-4308

1210 N Brown St
Vidant Womens Care Washington
Washington, NC 27889-4671
Phone (252) 975-1188

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

606 E 12TH St
Washington, NC 27889-3409
Phone (252) 974-9460

608 E 12TH St
Vidant Multispecialty Clinic Washiington
Washington, NC 27889-3409
Phone (252) 974-7500

628 E 12TH St
Vidant Beaufort Hospitalists
Washington, NC 27889-3409
Phone (252) 975-4178

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-03329NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Feb 20, 2017 Accepting new patients

Locations

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1202 Brown St
Washington, NC 27889
Phone (252) 943-0136

Interoperability endpoints

  • Direct secure messaging: ljenkins37590@direct.ecuhealth.com

Organizations & group practices 1

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 2

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": "1326758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1306117718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HEART DRIVE",
            "address_2": "ECU PHYSICIANS FAMILY MEDICINE",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278348944",
            "telephone_number": "252-744-4611",
            "fax_number": "252-744-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "LINDSAY",
        "middle_name": "YVONNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-17",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "STAGNER",
            "middle_name": "YVONNE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.