Individual provider Active NPI

Jay R Oswald, PA

  • Medical Physician Assistant
  • Tarboro, NC
National Provider Identifier
1427027010
Registry record updated Jan 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
103006 Issued in NC
Practice address
101 Clinic Dr
Tarboro, NC 27886-1935
Phone
(252) 823-7288
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 103006 NC Primary

Addresses

Primary practice location

101 Clinic Dr
Tarboro, NC 27886-1935

Mailing address

101 Clinic Dr
Tarboro, NC 27886-1935
Phone (252) 823-7288

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
I20040911000233 NC Practitioner - Physician Assistant 2961479738 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103006NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Dec 1, 2009 Accepting new patients
Vidant Medical Group LLC CurrentSince Dec 1, 2009 Accepting new patients

Locations

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

250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699

101 Clinic Dr
Tarboro, NC 27886
Phone (252) 823-2105

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

1705 Tarboro St SW
Wilson, NC 27893
Phone (252) 399-8040

1403 S King St
Windsor, NC 27983
Phone (252) 794-6685

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.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641686400000",
    "number": "1427027010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CLINIC DR",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278861935",
            "telephone_number": "252-823-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CLINIC DR",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278861935",
            "telephone_number": "252-823-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSWALD",
        "first_name": "JAY",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2022-01-09",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarboro, NC

Sources for this page

Verify at the official NPI Registry.