NPIMap

Individual provider Active NPI

Ivanna Jesslynn Ross, PA

  • Physician Assistant
  • Huntersville, NC
National Provider Identifier
1720701899
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15460 Issued in NC
Practice address
9930 Kincey Ave Ste 360
Huntersville, NC 28078-6541
Phone
(704) 316-4830
NPI assigned
Sep 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4679 SC
Physician Assistant 363A00000X 0010-15460 NC Primary

Addresses

Primary practice location

9930 Kincey Ave Ste 360
Huntersville, NC 28078-6541

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-4830

Other practice location 1

834 W Meeting St Ste E
Lancaster, SC 29720-6220
Phone (803) 285-5900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221207001491 SC Practitioner - Physician Assistant 3971972308 Reassigns benefits to 2 organizations
I20260526002012 NC Practitioner - Physician Assistant 3971972308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical University Hospital AuthorityGroup PAC ID 1557268950, shared by 43 NPIs, 218 clinicians

Practice addresses (Care Compare)

511 S Main St
Mullins, SC 29574-3509
Phone (843) 464-8244

834 W Meeting St
Lancaster, SC 29720-6220

Hospital & facility affiliations

  • Musc Health Lancaster Medical Center Hospital, Lancaster, SC, CCN 420036
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4679SCMDGeneral Practice Dentistry
0010-15460NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Dec 17, 2022 Accepting new patients
Medical University Hospital Authority CurrentSince Nov 7, 2022 Accepting new patients
Medical University Hospital Authority CurrentSince Nov 7, 2022 Accepting new patients
Musc Community Physicians CurrentSince Dec 17, 2022 Accepting new patients
Medical University Hospital Authority Past Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients
Medical University Hospital Authority Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1 Medical Park Dr
Ste C
Chester, SC 29706
Phone (803) 285-1411

834 W Meeting St
Ste E
Lancaster, SC 29720
Phone (803) 283-3775

834 W Meeting St
Ste A
Lancaster, SC 29720
Phone (803) 285-1411

511 S Main St
Mullins, SC 29574
Phone (843) 464-8244

Interoperability endpoints

  • Direct secure messaging: iross369291@direct.musc.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1720701899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 KINCEY AVE STE 360",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786541",
            "telephone_number": "704-316-4830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "834 W Meeting St Ste E",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "SC",
            "postal_code": "297206220",
            "country_code": "US",
            "telephone_number": "803-285-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSS",
        "first_name": "IVANNA",
        "middle_name": "JESSLYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4679",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "834 W Meeting St Ste E",
            "city": "Lancaster",
            "state": "SC",
            "country_code": "US",
            "postal_code": "297206220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.