NPIMap

Individual provider Active NPI

Jackson Genant, M.D.

  • Family Medicine Physician
  • Connelly Springs, NC
National Provider Identifier
1376586909
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9800052 Issued in NC
Practice address
730 Malcolm Blvd Ste 230
Connelly Springs, NC 28612-8079
Phone
(828) 580-2811
Fax
(828) 580-7083
NPI assigned
Jun 13, 2006
Last updated
Apr 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9800052 NC Primary

Addresses

Primary practice location

730 Malcolm Blvd Ste 230
Connelly Springs, NC 28612-8079

Mailing address

730 Malcolm Blvd Ste 230
Connelly Springs, NC 28612-8079
Phone (828) 580-2811

Other identifiers 1

IdentifierTypeStateIssuer
1376586909MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060106000729 NC Practitioner - Family Practice 1153344940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Sanford School of Medicine of University of South Dakota, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Weston Group IncGroup PAC ID 8123936796, shared by 8 NPIs, 215 clinicians

Practice addresses (Care Compare)

730 Malcolm Blvd
Suite 230
Connelly Springs, NC 28612-8079
Phone (828) 580-2811

7745 Little Ave
Charlotte, NC 28226-8168
Phone (704) 541-9333

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9800052NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Healthcare Medical Group, Inc. Current Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Jan 1, 2007 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Family Medicine CurrentSince Jan 1, 2007 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Family Medicine Past Accepting new patients
Carolina Inpatient Medical Specialists, PLLC Past Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Family Medicine Past Accepting new patients

Locations

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

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 7

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1376586909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 MALCOLM BLVD STE 230",
            "city": "CONNELLY SPRINGS",
            "state": "NC",
            "postal_code": "286128079",
            "telephone_number": "828-580-2811",
            "fax_number": "828-580-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 MALCOLM BLVD STE 230",
            "city": "CONNELLY SPRINGS",
            "state": "NC",
            "postal_code": "286128079",
            "telephone_number": "828-580-2811",
            "fax_number": "828-580-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENANT",
        "first_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9800052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376586909",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Connelly Springs, NC

Sources for this page

Verify at the official NPI Registry.