NPIMap

Individual provider Active NPI

Jimmy Patterson

  • Physician Assistant
  • Candor, NC
National Provider Identifier
1710975438
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103094 Issued in NC
Practice address
210 E Main St
Candor, NC 27229-8088
Phone
(910) 974-7555
NPI assigned
Oct 6, 2005
Last updated
Jul 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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 103094 NC Primary

Addresses

Primary practice location

210 E Main St
Candor, NC 27229-8088

Mailing address

835 Albemarle Rd
Troy, NC 27371-8682

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040311001105 NC Practitioner - Physician Assistant 9537058268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FHPG LLCGroup PAC ID 9537481569, 195 clinicians

Practice addresses (Care Compare)

104 Professional Dr
Biscoe, NC 27209-9835
Phone (910) 428-1544

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.84 of 100Reported as group
Quality
79.14
Promoting interoperability
92
Improvement activities
40
Cost
80.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103094NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jan 1, 2015 Accepting new patients
FHPG, LLC Family Medicine CurrentSince Feb 1, 2019 Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Jan 1, 2015 Accepting new patients
FHPG, LLC Family Medicine CurrentSince Feb 1, 2019 Accepting new patients
Central Piedmont Health Services, Inc Past Accepting new patients
FHPG, LLC Family Medicine Past Accepting new patients
Cabarrus Family Medicine Past Accepting new patients
Sandy River Family Care Inc Family Medicine PastSince Apr 27, 2009 Accepting new patients

Locations

301 Yadkin St
Albemarle, NC 28001
Phone (704) 984-4000

210 E Main St
Candor, NC 27229
Phone (910) 974-3116

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060

202 N Main St
Mount Gilead, NC 27306
Phone (910) 439-1573

269 S Main St
Norwood, NC 28128
Phone (704) 474-3171

835 Albemarle Rd
Troy, NC 27371
Phone (910) 572-2309

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/c32cb33f-ec61-4f25-9140-0b9b174fe4db/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tillery Compassionate CareAlbemarle, NC, CCN 341542 Hospice Corporate Director Jun 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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 5

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1710975438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 ALBEMARLE RD",
            "city": "TROY",
            "state": "NC",
            "postal_code": "273718682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E MAIN ST",
            "city": "CANDOR",
            "state": "NC",
            "postal_code": "272298088",
            "telephone_number": "910-974-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JIMMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Candor, NC

Sources for this page

Verify at the official NPI Registry.