Jordan Spake, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001011918 Issued in NC

Practice address

3714 Guardian Ave Ste E
Morehead City, NC 28557-2975

Phone

(910) 332-3800

Fax

(910) 251-0421

NPI assigned

Jan 30, 2021

Last updated

Dec 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042
• Carteret General Hospital Hospital, Morehead City, NC, CCN 340142

Merit-based Incentive Payment System (MIPS)

Final score

89.07 of 100Reported as group

Quality

85.94

Promoting interoperability

100

Improvement activities

40

Cost

77.63

Merit-based Incentive Payment System (MIPS)

Final score

90.19 of 100Reported as group

Quality

84.52

Promoting interoperability

100

Improvement activities

40

Cost

82.79

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jordan.spake.1@847.direct.athenahealth.com

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.

• Emergeortho PA

  • Orthopaedic Surgery Physician
  • Durham, NC
  • NPI 1376592964

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Emergeortho PA

  • Durable Medical Equipment & Medical Supplies
  • Eden, NC
  • NPI 1841170222
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carteret County General Hospital Corporation

  dba Carteret General Hospital

  • General Acute Care Hospital
  • Morehead City, NC
  • NPI 1760479331
  Care Compare affiliation
• Onslow Memorial Hospital Inc

  dba Onslow Memorial Hospital

  • General Acute Care Hospital
  • Jacksonville, NC
  • NPI 1679535496
  Care Compare affiliation

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

{
    "created_epoch": "1611964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1720679947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "919-220-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3714 GUARDIAN AVE STE E",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285572975",
            "telephone_number": "910-332-3800",
            "fax_number": "910-251-0421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3714 Guardian Ave Ste E",
            "address_purpose": "LOCATION",
            "city": "Morehead City",
            "state": "NC",
            "postal_code": "285572975",
            "country_code": "US",
            "telephone_number": "252-247-2101",
            "fax_number": "252-247-4675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPAKE",
        "first_name": "JORDAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-30",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001011918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Assisted Living, LLC. (Brookdale Morehead City)
• Southern Banks Baby, PLLC (Southern Banks Baby)
• Southmountain Children and Family Services
• Southmountain Children and Family Services
• Cynthia Louise Spaid, CRNA
• Julia C. Sparkman, APRN, CPNP
• John Raymond Spellman, MD
• Elsie M Spencer, FNP
• Nora Elizabeth Spires, MSW, LCSW
• James Nathanael Sprague, DC

• Physician Assistant in Morehead City, NC
• Providers in Morehead City, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.