Individual provider Active NPI

Justin Packer

  • Physician Assistant
  • Morehead City, NC
National Provider Identifier
1568819142
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4370 Arendell St Ste a
Morehead City, NC 28557-2800
Phone
(252) 222-0204
Fax
(252) 222-0433
NPI assigned
May 24, 2016
Last updated
May 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2024

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 NU Primary

Addresses

Primary practice location

4370 Arendell St Ste a
Morehead City, NC 28557-2800

Mailing address

306 Medical Park CT
Morehead City, NC 28557-4346
Phone (252) 247-2101

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address justin.packer.1@9526.direct.athenahealth.com Direct

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
I20161004000499 NC Practitioner - Physician Assistant 4981992195 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Urgent and Primary Care, P.a.Group PAC ID 5991220691, 6 clinicians

Practice addresses (Care Compare)

4370 Arendell St
Suite a
Morehead City, NC 28557-2800
Phone (252) 222-0204

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.19 of 100Reported as group
Quality
84.52
Promoting interoperability
100
Improvement activities
40
Cost
82.79

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: justin.packer.1@9526.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1568819142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 MEDICAL PARK CT",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285574346",
            "telephone_number": "252-247-2101",
            "fax_number": "252-247-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 ARENDELL ST STE A",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285572800",
            "telephone_number": "252-222-0204",
            "fax_number": "252-222-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKER",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justin.packer.1@9526.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4370 Arendell St Ste A",
            "city": "Morehead City",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285572800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

Verify at the official NPI Registry.