NPIMap

Individual provider Active NPI

Jennifer Ann Farres, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1598763054
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103568 Issued in NC
Practice address
2001 Randolph Rd
Charlotte, NC 28207-1215
Phone
(704) 323-2225
NPI assigned
Jul 8, 2005
Last updated
Jan 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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 103568 NC Primary

Addresses

Primary practice location

2001 Randolph Rd
Charlotte, NC 28207-1215

Mailing address

4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-2090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061215000466 NC Practitioner - Physician Assistant 2567461726 Reassigns benefits to 1 organization
I20090715000412 SC Practitioner - Physician Assistant 2567461726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians
Cora South Carolina LLCGroup PAC ID 3173766334, shared by 6 NPIs, 220 clinicians

Practice addresses (Care Compare)

1915 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 323-2282

2001 Randolph Rd
Charlotte, NC 28207-1215
Phone (704) 332-2225

2001 Vail Ave
Suite 200
Charlotte, NC 28207-1219
Phone (704) 323-2000

2536 Lengers Way
Fort Mill, SC 29707-7126
Phone (803) 313-3294

601 Sutton Rd S
Fort Mill, SC 29715-8439
Phone (803) 328-6306

851 Heckle Blvd
Rock Hill, SC 29730-2806
Phone (839) 388-0908

9101 Pineville Matthews Rd
Suite D
Pineville, NC 28134-8826
Phone (704) 323-3300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103568NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina Physician Assistant CurrentSince Jan 20, 2025 Accepting new patients
Orthocarolina Physician Assistant CurrentSince Mar 13, 2023 Accepting new patients
Orthocarolina, PA Physician Assistant CurrentSince Mar 13, 2023 Accepting new patients
Orthocarolina Physician Assistant Past Accepting new patients

Locations

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

2001 Randolph Rd
Charlotte, NC 28207
Phone (704) 323-2225

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

9101 Pineville Matthews Rd
Ste D
Pineville, NC 28134
Phone (704) 323-3300

601 Sutton Rd S
Ste 101
Fort Mill, SC 29715
Phone (803) 328-6303

2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294

Organizations & group practices 5

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 10

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1598763054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071215",
            "telephone_number": "704-323-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRES",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.