Individual provider Active NPI

Jonathan Mark Adams

  • Physician Assistant
  • Clemmons, NC
National Provider Identifier
1356720163
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05811 Issued in NC
Practice address
7210 Village Medical Cir Ste 110
Clemmons, NC 27012-8041
Phone
(336) 893-2400
NPI assigned
May 26, 2015
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-05811 NC Primary
Surgical Physician Assistant 363AS0400X

Addresses

Primary practice location

7210 Village Medical Cir Ste 110
Clemmons, NC 27012-8041

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JADAMS252170@DIRECT.NOVANTHEALTH.ORG

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
I20151016000436 NC Practitioner - Physician Assistant 3678882529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 277-1717

3333 Silas Pkwy
Winston-Salem, NC 27103-3013

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

6915 Village Medical Cir
Clemmons, NC 27012-8002
Phone (336) 718-7080

7210 Village Medical Cir
Clemmons, NC 27012-8029

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-05811NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Aug 10, 2015 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 10, 2015 Accepting new patients
Novant Medical Group, Inc. CurrentSince Aug 16, 2018 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

7210 Village Medical Cir
Ste 110
Clemmons, NC 27012
Phone (336) 893-2400

16525 Holly Crest Ln
Ste 150
Huntersville, NC 28078
Phone (704) 384-1725

144 Forest Hill Rd
Ste 144146
Lexington, NC 27295
Phone (336) 481-1730

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

211 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-1191

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: jadams252170@direct.novanthealth.org

Organizations & group practices 6

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 1

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": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1356720163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 VILLAGE MEDICAL CIR STE 110",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128041",
            "telephone_number": "336-893-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "JONATHAN",
        "middle_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05811",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JADAMS252170@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "211 Old Lexington Rd",
            "city": "Thomasville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "273603428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.