Individual provider Active NPI

Chelle Stinson Jeffery, PA-C

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1548436264
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102887 Issued in NC
Practice address
1941 New Garden Rd Ste 216
Greensboro, NC 27410-2555
Phone
(336) 288-8857
Fax
(336) 288-8769
NPI assigned
May 2, 2008
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 102887 NC Primary
Medical Physician Assistant 363AM0700X 102887 NC

Addresses

Primary practice location

1941 New Garden Rd Ste 216
Greensboro, NC 27410-2555

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cjeffrey722044@direct.novanthealth.org

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
I20050622001354 NC Practitioner - Physician Assistant 1456396100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1941 New Garden Rd
Suite 216
Greensboro, NC 27410-2555
Phone (336) 992-1351

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
Novant Medical Group, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1941 New Garden Rd
Ste 216
Greensboro, NC 27410
Phone (336) 288-8857

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: cjeffrey722044@direct.novanthealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1548436264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 NEW GARDEN RD STE 216",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102555",
            "telephone_number": "336-288-8857",
            "fax_number": "336-288-8769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERY",
        "first_name": "CHELLE",
        "middle_name": "STINSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-02",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102887",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "102887",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjeffrey722044@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1941 New Garden Rd Ste 216",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274102555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.