Individual provider Active NPI

Jarrett Melanie McWhorter, PA-C

  • Physician Assistant
  • Daytona Beach, FL
National Provider Identifier
1417710393
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9118319 Issued in FL
Practice address
1530 Cornerstone Blvd Ste 120
Daytona Beach, FL 32117-7129
Phone
(386) 310-2160
Fax
(386) 310-2106
NPI assigned
Feb 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9118319 FL Primary

Addresses

Primary practice location

1530 Cornerstone Blvd Ste 120
Daytona Beach, FL 32117-7129

Mailing address

145 McWhorter Dr
Fitzgerald, GA 31750-5901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240220004715 FL Practitioner - Physician Assistant 6800230616 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9118319FLMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1417710393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 MCWHORTER DR",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317505901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 CORNERSTONE BLVD STE 120",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177129",
            "telephone_number": "386-310-2160",
            "fax_number": "386-310-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWHORTER",
        "first_name": "JARRETT",
        "middle_name": "MELANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9118319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.