Individual provider Active NPI

Joseph Allen Mihalovich

  • Physician Assistant
  • Kernersville, NC
National Provider Identifier
1386144574
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07928 Issued in NC
Practice address
1471 Jag Branch Blvd Unit 103
Kernersville, NC 27284-6963
Phone
(336) 515-7410
Fax
(336) 515-7419
NPI assigned
Feb 14, 2018
Last updated
Jan 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 0010-07928 NC Primary
Psychiatry Physician 2084P0800X 1891867115 NC

Addresses

Primary practice location

1471 Jag Branch Blvd Unit 103
Kernersville, NC 27284-6963

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1308 Highland Dr
Washington, NC 27889-3424
Phone (252) 946-3666

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address knall17288@direct.vidanthealth.com
Direct Messaging Address jmihalovich274583@direct.vidanthealth.com

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
I20180509002809 NC Practitioner - Physician Assistant 4385908896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1471 Jag Branch Blvd
Suite 103
Kernersville, NC 27284-6956
Phone (336) 515-7410

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1891867115NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Dec 16, 2022 Accepting new patients
Vidant Medical Group LLC CurrentSince Feb 19, 2018 Accepting new patients
Noant Medical Group, Inc CurrentSince Dec 16, 2022 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1471 Jag Branch Blvd
Unit 103
Kernersville, NC 27284
Phone (336) 515-7410

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

1308 Highland Dr
Washington, NC 27889
Phone (252) 946-3666

628 E 12th St
Washington, NC 27889
Phone (252) 975-4100

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

Interoperability endpoints

  • Direct secure messaging: jmihalovich1100094@direct.novanthealth.org
  • Direct secure messaging: jmihalovich274583@direct.vidanthealth.com
  • Direct secure messaging: knall17288@direct.vidanthealth.com

Organizations & group practices 5

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": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1386144574",
    "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": "1471 JAG BRANCH BLVD UNIT 103",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272846963",
            "telephone_number": "336-515-7410",
            "fax_number": "336-515-7419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1308 Highland Dr",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "NC",
            "postal_code": "278893424",
            "country_code": "US",
            "telephone_number": "252-946-3666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIHALOVICH",
        "first_name": "JOSEPH",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-14",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07928",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "1891867115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knall17288@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmihalovich274583@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.