Jeral W Carr, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9102567 Issued in FL

Practice address

1289 SW State Road 47
Lake City, FL 32025-0484

Phone

(386) 755-0421

Fax

(386) 487-1234

NPI assigned

Apr 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Medical Urgent Care CenterGroup PAC ID 1456578665, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Mercy Medical Urgent Care Center

  • Urgent Care Clinic/Center
  • Lake City, FL
  • NPI 1891113064
  Medicare reassignment Care Compare group
• Nahed S. Sobhy M.D. P.a.

  • Urgent Care Clinic/Center
  • Lake City, FL
  • NPI 1730469362
  NPD

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1326002452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1289 SW STATE ROAD 47",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250484",
            "telephone_number": "386-755-0421",
            "fax_number": "386-487-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 SW STATE ROAD 47",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250484",
            "telephone_number": "386-755-0421",
            "fax_number": "386-487-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "JERAL",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE #",
            "identifier": "PA9102567",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY CODE",
            "identifier": "363A00000X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maelyn Lee Carlucci
• Kayla Carman
• Denise Lynn Carmichael, FNP-C
• Troynesha R Carodine
• John M Caroline, D.O.
• Patricia Carr, ARNP
• Brittany Carter
• Carolyn Carter, PHD
• Emily Carter
• Tracey T Carter, LMSW

• Physician Assistant in Lake City, FL
• Providers in Lake City, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; 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.