Individual provider Active NPI

Nichole Jones, PA-C

  • Surgical Physician Assistant
  • Jacksonville, NC
National Provider Identifier
1720455124
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3518-23 Issued in WI
Practice address
55 Office Park Dr
Jacksonville, NC 28546-7327
Phone
(910) 219-3377
NPI assigned
Sep 1, 2015
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 320724 NC
Surgical Physician Assistant 363AS0400X 3518-23 WI Primary

Addresses

Primary practice location

55 Office Park Dr
Jacksonville, NC 28546-7327

Mailing address

205 Trophy Ridge Dr
Richlands, NC 28574-8490
Phone (239) 340-3969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150923001180 WI Practitioner - Physician Assistant 4688981608 Reassigns benefits to 2 organizations
I20240403002631 NC Practitioner - Physician Assistant 4688981608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onslow Ambulatory Services IncGroup PAC ID 4587569256, 18 clinicians

Practice addresses (Care Compare)

55 Office Park Dr
Jacksonville, NC 28546-7327
Phone (910) 219-3377

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.53 of 100Reported as group
Quality
90.05
Promoting interoperability
100
Improvement activities
40
Cost
75.04

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
320724NCMDSurgical Physician Assistant
3518-23WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
Onslow Ambulatory Services, Inc. CurrentSince Mar 18, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Onslow Ambulatory Services, Inc. CurrentSince Mar 18, 2024 Accepting new patients
Marshfield Clinic Inc CurrentSince Nov 2, 2015 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients

Locations

55 Office Park Dr
Jacksonville, NC 28546
Phone (910) 219-3377

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

Interoperability endpoints

  • Direct secure messaging: nichole.jones@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 7

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": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1720455124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 TROPHY RIDGE DR",
            "city": "RICHLANDS",
            "state": "NC",
            "postal_code": "285748490",
            "telephone_number": "239-340-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 OFFICE PARK DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467327",
            "telephone_number": "910-219-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "NICHOLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "320724",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "3518-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.