Active NPI
Paige Jernigan, PTA
- Physical Therapy Assistant
- Statesville, NC
National Provider Identifier
1548950439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A8079
- Practice address
- 2001 Van Haven Dr
Statesville, NC 28625-4342 - Phone
- (704) 883-9700
- NPI assigned
- May 12, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A8079 | ND | Primary |
Addresses
Primary practice location
2001 Van Haven Dr
Statesville, NC 28625-4342
Mailing address
117 S Avondale Rd
Lexington, NC 27292-5805
Phone (336) 465-3315
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A8079 | ND | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683849600000",
"number": "1548950439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 S AVONDALE RD",
"city": "LEXINGTON",
"state": "NC",
"postal_code": "272925805",
"telephone_number": "336-465-3315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 VAN HAVEN DR",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286254342",
"telephone_number": "704-883-9700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JERNIGAN",
"first_name": "PAIGE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-12",
"last_updated": "2023-05-12",
"certification_date": "2023-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "ND",
"license": "A8079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Statesville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.