Individual provider Active NPI

Jessica Matthews Belk, PAC

  • Medical Physician Assistant
  • Charlotte, NC
National Provider Identifier
1316232697
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-02936 Issued in NC
Practice address
700 E Morehead St
Ste 300
Charlotte, NC 28202-2788
Phone
(704) 334-7800
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-02936 NC Primary

Addresses

Primary practice location

700 E Morehead St
Ste 300
Charlotte, NC 28202-2788

Mailing address

700 E Morehead St
Ste 300
Charlotte, NC 28202-2788
Phone (704) 334-7800

Other identifiers 2

IdentifierTypeStateIssuer
1316232697MedicaidNC
1464PAMedicaidSC

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
I20110728000123 NC Practitioner - Physician Assistant 1052589520 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
Charlotte Radiology PAGroup PAC ID 4587577390, 222 clinicians

Practice addresses (Care Compare)

Charlotte, NC 28203
Phone (704) 362-5391

724 Aubrey Bell Dr
Matthews, NC 28105-5055
Phone (704) 295-3550

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 612-4955

920 Church St N
Concord, NC 28025-2927
Phone (704) 334-7800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Radiology P a CurrentSince Sep 1, 2015 Accepting new patients

Locations

12335 N Community House Rd
Ste B
Charlotte, NC 28277

700 E Morehead St
Ste 300
Charlotte, NC 28202
Phone (704) 442-4390

724 Aubrey Bell Dr
Matthews, NC 28105
Phone (704) 295-3550

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 and National Provider Directory roles.

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": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1316232697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022788",
            "telephone_number": "704-334-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022788",
            "telephone_number": "704-334-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELK",
        "first_name": "JESSICA",
        "middle_name": "MATTHEWS",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316232697",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1464PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.