Individual provider Active NPI

Jesse Michael Myers

  • Physician Assistant
  • Leland, NC
National Provider Identifier
1356849111
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07825 Issued in NC
Practice address
1333 S Dickinson Dr Unit 140
Leland, NC 28451-6434
Phone
(910) 341-3300
Fax
(910) 251-2067
NPI assigned
Jan 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07825 NC Primary

Addresses

Primary practice location

1333 S Dickinson Dr Unit 140
Leland, NC 28451-6434

Mailing address

1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 341-3300

Other practice location 1

1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 341-3300

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
I20180309000033 NC Practitioner - Physician Assistant 9436410347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Brody School of Medicine at East Carolina University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

1222 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

2421 Silver Stream LN
Wilmington, NC 28401-7684
Phone (910) 341-1540

8064 Market St
Wilmington, NC 28411-9384
Phone (910) 341-1540

8068 Market St
Wilmington, NC 28411-9384
Phone (910) 796-7767

8090 Market St
Wilmington, NC 28411-9384
Phone (910) 341-1540

8108 B Market St
Wilmington, NC 28411-9386
Phone (910) 341-1540

8114 Market St
Suite 200
Wilmington, NC 28411-9386
Phone (910) 341-1540

9101 Ocean Hwy E
Leland, NC 28451-7867
Phone (910) 341-1540

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-07825NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington ASC LLC CurrentSince Jan 29, 2018 Accepting new patients
Wilmington Health PLLC CurrentSince Jan 29, 2018 Accepting new patients

Locations

1333 S Dickinson Dr
Unit 140
Leland, NC 28451
Phone (910) 662-6600

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

Interoperability endpoints

  • Direct secure messaging: jesse.myers.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations & group practices 2

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 6

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": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1356849111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 S DICKINSON DR UNIT 140",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516434",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1202 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017307",
            "country_code": "US",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JESSE",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, NC

Sources for this page

Verify at the official NPI Registry.