Jason Edward Guevara, M.D.
Individual provider Active NPI Orthopaedic Surgery Physician · West End, NC
NPI 1689680787 · NPPES record last updated Apr 7, 2016
Key facts
- NPI
- 1689680787
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 9901414 (NC)
- Practice address
- 4208 Murdocksville Rd
West End, NC 27376-8871 - Phone
- (910) 295-7070
- Fax
- (910) 295-7447
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040205000442 | NC | Practitioner - Orthopedic Surgery | 0042112476 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9901414 | NC | MD | Orthopaedic Surgery Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 9901414 | NC | Yes |
Addresses
Primary practice location
4208 Murdocksville Rd
West End, NC 27376-8871
Mailing address
4208 Murdocksville Rd
West End, NC 27376-8871
Phone (910) 295-7070
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200039797 | Other | RAILROAD MEDICARE | |
| 12586 | Other | BCBS NC | |
| 8912586 | Medicaid | NC |
Other providers in West End, NC
- Kerry Goldman
- Stephanie Graves
- Kimberly G Greer
- John Mark Griffies
- Emily Fancher Grimaldi
- Guided Counseling and Wellness PLLC
- Deena Haley
- Kelsey Raap Halpern
- Alfonso Haro
- Jennifer Harvey
All providers in West End, NC · Orthopaedic Surgery Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.