Individual provider Active NPI

Jacob Alan Jennings, PA-C

  • Physician Assistant
  • Franklin, NC
National Provider Identifier
1699058636
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-03138 Issued in NC
Practice address
120 Riverview St
Franklin, NC 28734-2612
Phone
(828) 524-8411
Fax
(828) 524-2712
NPI assigned
Sep 26, 2011
Last updated
Nov 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

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 0010-03138 NC Primary

Addresses

Primary practice location

120 Riverview St
Franklin, NC 28734-2612

Mailing address

PO Box 1209
Franklin, NC 28744-0569
Phone (828) 213-1500

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
I20150501000770 NC Practitioner - Physician Assistant 2961721618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Carolina Ear Nose and Throat Specialists PLLCGroup PAC ID 5193731800, 2 clinicians

Practice addresses (Care Compare)

63 Haywood Park Dr
Clyde, NC 28721-4404
Phone (828) 627-1234

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: jacob.jennings@wcents.eclinicaldirectplus.com

Organizations & group practices 1

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 4

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": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448409600000",
    "number": "1699058636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1209",
            "city": "FRANKLIN",
            "state": "NC",
            "postal_code": "287440569",
            "telephone_number": "828-213-1500",
            "fax_number": "828-651-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 RIVERVIEW ST",
            "city": "FRANKLIN",
            "state": "NC",
            "postal_code": "287342612",
            "telephone_number": "828-524-8411",
            "fax_number": "828-524-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JACOB",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-26",
        "last_updated": "2015-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, NC

Sources for this page

Verify at the official NPI Registry.