Individual provider Active NPI

Jeffrey Robert Dore, PA

  • Physician Assistant
  • Brevard, NC
National Provider Identifier
1477069854
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-007803 Issued in NC
Practice address
371 Asheville Hwy
Brevard, NC 28712
Phone
(248) 760-3720
NPI assigned
Dec 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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 0010-007803 NC Primary

Addresses

Primary practice location

371 Asheville Hwy
Brevard, NC 28712

Mailing address

212 Thompson St
Ste a
Hendersonville, NC 28792-2895
Phone (828) 697-3232

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
I20180322001815 NC Practitioner - Physician Assistant 9133481591 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henderson County Hospital CorporationGroup PAC ID 8123938115, 231 clinicians

Practice addresses (Care Compare)

6503 Brevard Rd
Etowah, NC 28729-8739
Phone (828) 890-4156

800 N Justice St
Hendersonville, NC 28791-3410
Phone (828) 696-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-007803NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson County Hospital Corporation CurrentSince Nov 30, 2020 Accepting new patients
Henderson County Hospital Corporation CurrentSince Nov 30, 2020 Accepting new patients
Henderson County Hospital Corporation PastSince Nov 8, 2020 Accepting new patients

Locations

21 Turtle Creek Dr
Ste 100
Asheville, NC 28803
Phone (828) 435-8394

800 N Justice St
Hendersonvlle, NC 28791
Phone (828) 696-1000

Interoperability endpoints

  • Direct secure messaging: jdore216171@direct.unc.nchie.net

Organizations & group practices 5

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": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1477069854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 THOMPSON ST",
            "address_2": "STE A",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287922895",
            "telephone_number": "828-697-3232",
            "fax_number": "828-698-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 ASHEVILLE HWY",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "28712",
            "telephone_number": "248-760-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORE",
        "first_name": "JEFFREY",
        "middle_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-20",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-007803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brevard, NC

Sources for this page

Verify at the official NPI Registry.