Individual provider Active NPI

Jillian Gray Patton, FNP-BC

  • Family Nurse Practitioner
  • Fleetwood, NC
National Provider Identifier
1346965134
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
32658 Issued in TN
Practice address
1729 Cranberry Springs Rd
Fleetwood, NC 28626-9851
Phone
(540) 450-7795
NPI assigned
Oct 5, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PC 409 clinicians

Practice addresses (Care Compare)

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Merit-based Incentive Payment System (MIPS)

Final score
75.12 of 100Reported as group
Quality
64.75
Improvement activities
40

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA, SC3 enrollments
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.

Medicare enrollment records 3

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20230420000347 TN Practitioner - Nurse Practitioner 4880059195 Reassigns benefits to 1 organization
I20230614004242 VA Practitioner - Nurse Practitioner 4880059195 Reassigns benefits to 1 organization
I20251006000384 SC Practitioner - Nurse Practitioner 4880059195 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
32658TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC CurrentSince Jun 7, 2025 Accepting new patients
Tri-Cities Regional Emergency Physicians, PC CurrentSince Mar 11, 2023 Accepting new patients
Western Virginia Regional Emergency Physicians, LLC CurrentSince May 1, 2023 Accepting new patients

Locations

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

2000 Brookside Dr
Kingsport, TN 37660
Phone (423) 857-7144

16000 Johnston Memorial Dr
Abingdon, VA 24211
Phone (276) 258-1000

100 15th St NW
Norton, VA 24273
Phone (276) 439-1000

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 32658 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

1729 Cranberry Springs Rd
Fleetwood, NC 28626-9851

Mailing address

1729 Cranberry Springs Rd
Fleetwood, NC 28626-9851
Phone (540) 450-7795

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 30, 2024.

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1346965134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 CRANBERRY SPRINGS RD",
            "city": "FLEETWOOD",
            "state": "NC",
            "postal_code": "286269851",
            "telephone_number": "540-450-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 CRANBERRY SPRINGS RD",
            "city": "FLEETWOOD",
            "state": "NC",
            "postal_code": "286269851",
            "telephone_number": "540-450-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON",
        "first_name": "JILLIAN",
        "middle_name": "GRAY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "32658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleetwood, NC

Sources for this page

Verify at the official NPI Registry.