Jaclyn Elizabeth Ladner, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-13404 Issued in NC

Practice address

202 Malloy St Ste B
Goldsboro, NC 27534-4477

Phone

(919) 751-7665

NPI assigned

Jul 31, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Van L. Adams M. D., PLLC

  • Primary Care Clinic/Center
  • Goldsboro, NC
  • NPI 1124460514
  Medicare reassignment
• Wilson Family Practice Center Inc

  • Family Medicine Physician
  • Wilson, NC
  • NPI 1184797235
  NPD (past)

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1558042705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 MALLOY ST STE B",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344477",
            "telephone_number": "919-751-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 MALLOY ST STE B",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344477",
            "telephone_number": "919-751-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADNER",
        "first_name": "JACLYN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-13404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Krutsch, FNP
• John Paul Kumhyr, PA
• Kyle J Roth III DDS PA
• Kyle Roth and Associates VI, DDS, PA
• Laboratory Corporation of America Holdings
• Mark Steven Lafave, M.D.
• Scott O Lafevers, DDS MBA
• Lakeview
• Natasha Mae Lamar
• Linwood Lambert

• Medical Physician Assistant in Goldsboro, NC
• Providers in Goldsboro, 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 Dec 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.