Jarred Fisher, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-08030 Issued in NC

Practice address

908 S Williamson Ave
Elon, NC 27244-9280

Phone

(336) 538-2416

NPI assigned

Apr 16, 2018

Last updated

Apr 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Functionalcare 360

  • Primary Care Clinic/Center
  • Charlotte, NC
  • NPI 1952141475
  NPD Authorized official

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1467949438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 BARBEE ST",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272171004",
            "telephone_number": "331-442-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 S WILLIAMSON AVE",
            "city": "ELON",
            "state": "NC",
            "postal_code": "272449280",
            "telephone_number": "336-538-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "JARRED",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-08030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE NUMBER",
            "identifier": "0010-08030",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elon University
• Elon Village Homes, Inc.
• Alexandra Evans, PA
• Devron John Felder
• Kristin Fick
• Marisa C Flores, MD
• Annamaria Folkerts, PAC
• Generation Change Inc
• Claudine Gerber, MS, MSW
• Gods Divine Purpose

• Medical Physician Assistant in Elon, NC
• Providers in Elon, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.