Harris Jesse Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07459 Issued in NC

Practice address

240 Smith Church Rd Ste a
Roanoke Rapids, NC 27870-4900

Phone

(252) 535-1082

NPI assigned

Mar 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vidant Medical Group LLC 986 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ecu Health North Hospital Hospital, Roanoke Rapids, NC, CCN 340151

Merit-based Incentive Payment System (MIPS)

Final score

96.95 of 100Reported as apm

Quality

82.44

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hsmith411204@direct.ecuhealth.com

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.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731

  NC

  Medicare reassignment Care Compare group NPD
• Vidant Medical Group LLC

  • Ambulatory Surgical Clinic/Center
  • Kinston, NC
  • NPI 1376049619
  Care Compare group
• Vidant Medical Group, LLC

  • Cardiac Rehabilitation Clinic/Center
  • Roanoke Rapids, NC
  • NPI 1750125035
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Halifax Regional Medical Center Inc

  • General Acute Care Hospital
  • Roanoke Rapids, NC
  • NPI 1346273943

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1326313719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 SMITH CHURCH RD STE A",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704914",
            "telephone_number": "252-535-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 SMITH CHURCH RD STE A",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704900",
            "telephone_number": "252-535-1082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Duke Medicine Cir",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277104000",
            "country_code": "US",
            "telephone_number": "919-681-1948",
            "fax_number": "910-681-1948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2153 Valleygate Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043667",
            "country_code": "US",
            "telephone_number": "910-321-7246",
            "fax_number": "910-321-7245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HARRIS",
        "middle_name": "JESSE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-19",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "2013",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Skaggs
• Skill Creations Inc
• Smith Church Obstetrics & Gynecology, PC
• Chester Smith
• Christine E Smith, OTR/L
• Princess Smith
• Douglas Hardy Snow, DO
• Soft Life Co
• Yvonne Solomon, LPC
• Michael Dean Sorensen, M.D.

• All providers in Roanoke Rapids, NC
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.