John Illsley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07223 Issued in NC

Practice address

702 N Main St
Roxboro, NC 27573-4755

Phone

(336) 599-9271

Fax

(336) 599-9271

NPI assigned

May 2, 2017

Last updated

Jun 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• John Illsley Other name

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

Specialty

Physician Assistant

Education

University of Pittsburgh School of Medicine, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Person Family Medical Center IncorporatedGroup PAC ID 9436123379, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Person Memorial Hospital Hospital, Roxboro, NC, CCN 340159

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Person Family Medical Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Roxboro, NC
  • NPI 1952493587
  Medicare reassignment Care Compare group
• Person Family Medical Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Roxboro, NC
  • NPI 1194899542
  NPD (past)

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

• DLP Person Memorial Hospital LLC

  dba Person Memorial Hospital

  • General Acute Care Hospital
  • Roxboro, NC
  • NPI 1881977593
  Care Compare affiliation

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1598291163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 N MAIN ST",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734755",
            "telephone_number": "561-350-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N MAIN ST",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734755",
            "telephone_number": "336-599-9271",
            "fax_number": "336-599-9271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 Darrington Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275138157",
            "country_code": "US",
            "telephone_number": "919-354-7077",
            "fax_number": "919-354-7075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILLSLEY",
        "first_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-02",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598291163",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "ILLSLEY",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary Bennett Houston, D.D.S.
• Jamie Blythe Huff, RPH
• Richard Hultz, PT
• La Monica Hunter, CPNP
• Daphne Ashley Hutchins
• Insight Awaken PLLC
• Integrative Communtiy Solutions, LLC
• J-1 Consultants LLC
• J-1 Consultants LLC
• Brianna Elizabeth Jackson

• Physician Assistant in Roxboro, NC
• Providers in Roxboro, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.