NPIMap

Individual provider Active NPI

Anna-Margaret Chauncey Jazayeri, P.A.-C

  • Physician Assistant
  • Hatteras, NC
National Provider Identifier
1487600631
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
57635 NC Hwy 12
Hatteras, NC 27943
Phone
(282) 986-2756
NPI assigned
May 26, 2006
Last updated
Mar 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Medical Physician Assistant 363AM0700X 104023 NC
Medical Physician Assistant 363AM0700X 9104636 FL

Addresses

Primary practice location

57635 NC Hwy 12
Hatteras, NC 27943

Mailing address

Pob 602
Hatteras, NC 27943
Phone (252) 347-6512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040804001307 NC Practitioner - Physician Assistant 5890766687 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9104636FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Horizons Center, Inc CurrentSince May 1, 2017 Accepting new patients
Coastal Horizons Center Inc CurrentSince May 1, 2017 Accepting new patients
Wilmington Treatment Center, LLC CurrentSince Apr 1, 2020 Accepting new patients
ENT and Allergy Associates of Florida, LLC Past Accepting new patients
Heatheast Outer Banks Medical Center LLC Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Hatteras Village Medical Center, Inc. Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients
Robert W Patterson MD PA Past Accepting new patients
Coastal Rehabilitation Associates PastSince Jul 8, 1996 Accepting new patients
Washington Township Past Accepting new patients
Carolinas Physicians Network Inc Past Accepting new patients

Locations

120 Coastal Horizons Dr
Shallotte, NC 28470
Phone (910) 754-4515

615 Shipyard Blvd
Wilmington, NC 28412
Phone (910) 202-5709

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1487600631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POB 602",
            "city": "HATTERAS",
            "state": "NC",
            "postal_code": "27943",
            "telephone_number": "252-347-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57635 NC HWY 12",
            "city": "HATTERAS",
            "state": "NC",
            "postal_code": "27943",
            "telephone_number": "282-986-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAZAYERI",
        "first_name": "ANNA-MARGARET",
        "middle_name": "CHAUNCEY",
        "name_prefix": "Ms.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "104023",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9104636",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hatteras, NC

Sources for this page

Verify at the official NPI Registry.