Individual provider Active NPI

Jessica Marie Easley

  • Family Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1639821010
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5015521 Issued in NC
Practice address
1210 New Garden Rd
Greensboro, NC 27410-2721
Phone
(336) 294-6190
NPI assigned
Jan 26, 2022
Last updated
Apr 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5015521 NC Primary
Registered Nurse 163W00000X 270638 NC

Addresses

Primary practice location

1210 New Garden Rd
Greensboro, NC 27410-2721

Mailing address

195 DC Oakley Rd
Burlington, NC 27217-9330
Phone (336) 514-3549

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jessica.easley@eaglep.eclinicaldirectplus.com

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
I20220614001275 NC Practitioner - Nurse Practitioner 4688053127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greensboro Medical Associates, P.a.Group PAC ID 6406751460, 9 clinicians

Practice addresses (Care Compare)

1511 Westover Ter
Suite 201
Greensboro, NC 27408-7131
Phone (336) 373-0611

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
270638NCMDRegistered Nurse
5015521NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greensboro Medical Associates, P.a. CurrentSince Jun 1, 2023 Accepting new patients
Eagle Physicians and Associates PA Family CurrentSince Apr 18, 2022 Accepting new patients
Eagle Physicians and Associates PA CurrentSince Apr 18, 2022 Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients

Locations

1511 Westover Ter
Ste 20
Greensboro, NC 27408

1511 Westover Ter
Ste 201
Greensboro, NC 27408
Phone (336) 333-7878

324 W Wendover Ave
Ste 200
Greensboro, NC 27408
Phone (336) 274-6515

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAIIBA
  • Direct secure messaging: jessica.easley@gsoma.eclinicaldirectplus.com

Organizations & group practices 4

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": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1639821010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 DC OAKLEY RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272179330",
            "telephone_number": "336-514-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 NEW GARDEN RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102721",
            "telephone_number": "336-294-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASLEY",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015521",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "270638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.easley@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1210 New Garden Rd",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274102721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.