Active NPI
Jennifer Lynn Forbes, PA
- Physician Assistant
- Elizabeth City, NC
National Provider Identifier
1386832681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001001368
- Practice address
- 1141 N Road St
Suite G
Elizabeth City, NC 27909-3354 - Phone
- (252) 335-5424
- Fax
- (252) 335-1077
- NPI assigned
- Oct 11, 2007
- Last updated
- Aug 29, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 470 | AL | |
| Physician Assistant | 363A00000X | 001001368 | NC | Primary |
Addresses
Primary practice location
1141 N Road St
Suite G
Elizabeth City, NC 27909-3354
Mailing address
1141 N Road St
Suite G
Elizabeth City, NC 27909-3354
Phone (252) 335-5424
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51544933 | Other | AL | BCBS |
| 292931700 | Medicaid | FL | |
| 009913146 | Medicaid | AL | |
| 05309207 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001001368 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219968000000",
"number": "1386832681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1141 N ROAD ST",
"address_2": "SUITE G",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279093354",
"telephone_number": "252-335-5424",
"fax_number": "252-335-1077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1141 N ROAD ST",
"address_2": "SUITE G",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279093354",
"telephone_number": "252-335-5424",
"fax_number": "252-335-1077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORBES",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-11",
"last_updated": "2008-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AL",
"license": "470",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "001001368",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51544933",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "292931700",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009913146",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05309207",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.