Individual provider Active NPI

Jama Lee Hare, PA

  • Physician Assistant
  • Wilmington, NC
National Provider Identifier
1669448379
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07953 Issued in NC
Practice address
2131 S 17TH St
Wilmington, NC 28401-7407
Phone
(910) 667-2606
Fax
(910) 815-5698
NPI assigned
Feb 23, 2006
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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 0010-07953 NC Primary

Addresses

Primary practice location

2131 S 17TH St
Wilmington, NC 28401-7407

Mailing address

PO Box 936857
Atlanta, GA 31193-6857

Other practice location 1

2131 S 17th St
Wilmington, NC 28401-7407
Phone (910) 815-5830

Other practice location 2

1509 Doctors Cir
Bldg C
Wilmington, NC 28401-7403
Phone (910) 662-7500

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Ambulatory@direct.carolinashealthcare.org Atrium Health
Direct Messaging Address jhare119809@direct.nhrmc.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NC2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090626000515 CO Practitioner - Physician Assistant 6406907732 Reassigns benefits to 2 organizations
I20181120000402 NC Practitioner - Physician Assistant 6406907732 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1416COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
NMG Health Services LLC CurrentSince May 1, 2021 Accepting new patients
Usacs of Colorado, Inc CurrentSince Jan 1, 2009 Accepting new patients
Usacs Observation Medicine Services of Colorado Inc. CurrentSince May 1, 2017 Accepting new patients
Usacs Observation Medicine Services of Colorado, Inc CurrentSince May 1, 2017 Accepting new patients
Usacs of Colorado Inc CurrentSince Jan 1, 2009 Accepting new patients
Novant Health Medical Group Coastal Region, LLC CurrentSince May 1, 2021 Accepting new patients

Locations

11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010

7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

1509 Doctors Cir
Bldg C
Wilmington, NC 28401
Phone (910) 662-7550

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

Interoperability endpoints

  • Direct secure messaging: jhare1426234@direct.novanthealth.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1669448379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-667-2606",
            "fax_number": "910-815-5698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2131 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017407",
            "country_code": "US",
            "telephone_number": "910-815-5830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1509 Doctors Cir",
            "address_2": "Bldg C",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017403",
            "country_code": "US",
            "telephone_number": "910-662-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARE",
        "first_name": "JAMA",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1509 Doctors Cir",
            "address_2": "Bldg C",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284017403",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhare119809@direct.nhrmc.org",
            "affiliation": "N",
            "address_1": "1509 Doctors Cir",
            "address_2": "Bldg C",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284017403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.