Jackson Genant, M.D.
Individual provider Active NPI Family Medicine Physician · Connelly Springs, NC
NPI 1376586909 · NPPES record last updated Apr 20, 2018
Key facts
- NPI
- 1376586909
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 9800052 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 7
Medicare Care Compare profile
- 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
- Blue Ridge Healthcare Medical Group Inc
The Weston Group Inc
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
- Gentiva Health Services
- Atrium Health at Home Blue Ridge
- Blue Ridge Healthcare Hospitals, Inc
- Caldwell Memorial Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060106000729 | NC | Practitioner - Family Practice | 1153344940 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9800052 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | Current |
Accepting new patients |
| Blue Ridge Healthcare Medical Group, Inc. | Current | Accepting new patients | |
| Blue Ridge Healthcare Medical Group, Inc. | Current |
Accepting new patients | |
| Carolina Inpatient Medical Specialists, PLLC | Past | Accepting new patients | |
| Blue Ridge Healthcare Medical Group, Inc. | Family Medicine | 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9800052 | NC | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376586909 | Medicaid | NC |
Other providers in Connelly Springs, NC
- Amanda Ford
- Joseph Eric Franklin
- Nicole Lauren Gaines
- Gaston Family Health Services, Inc
- Gaston Family Health Services, Inc
- Angela Gouge
- Quincy Justin Greene
- Shawn M Hamm
- Landon John Hamren
- Amber Michelle Harding
All providers in Connelly Springs, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.