Individual provider Active NPI

Bill Jack Parker, M.D.

  • Family Medicine Physician
  • Newton, NC
National Provider Identifier
1407854441
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38402 Issued in NC
Practice address
3121 Plateau Rd
Newton, NC 28658-8900
Phone
(704) 276-9200
Fax
(704) 276-9300
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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 38402 NC Primary

Addresses

Primary practice location

3121 Plateau Rd
Newton, NC 28658-8900

Mailing address

3121 Plateau Rd
Newton, NC 28658-8900
Phone (704) 276-9200

Other identifiers 1

IdentifierTypeStateIssuer
7965234MedicaidNC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080725000321 NC Practitioner - Family Practice 2062585946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3121 Plateau Rd
Newton, NC 28658-8900
Phone (704) 276-9200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38402NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Family Medical Care P.a. Family Medicine CurrentSince Jan 1, 2008 Accepting new patients
Catawba Radiological Associates, Inc. PastSince Jan 1, 2008 Accepting new patients

Locations

3121 Plateau Rd
Newton, NC 28658
Phone (704) 276-9200

Interoperability endpoints

  • Direct secure messaging: billjack-parker@crossroadsfamilymedicalcare.e-mdsdirect.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 3

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1407854441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 PLATEAU RD",
            "city": "NEWTON",
            "state": "NC",
            "postal_code": "286588900",
            "telephone_number": "704-276-9200",
            "fax_number": "704-276-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 PLATEAU RD",
            "city": "NEWTON",
            "state": "NC",
            "postal_code": "286588900",
            "telephone_number": "704-276-9200",
            "fax_number": "704-276-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "BILL",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "38402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7965234",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, NC

Sources for this page

Verify at the official NPI Registry.