Individual provider Active NPI

Tessa Jeanne Rayne, PA-C

  • Physician Assistant
  • Hertford, NC
National Provider Identifier
1750111373
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
600 S Church St
Hertford, NC 27944-1205
Phone
(252) 426-5711
Fax
(252) 426-1999
NPI assigned
Aug 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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 Primary

Addresses

Primary practice location

600 S Church St
Hertford, NC 27944-1205

Mailing address

600 S Church St
Hertford, NC 27944-1205
Phone (715) 307-4662

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
I20250226001664 NC Practitioner - Physician Assistant 6002336682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Carolina Family Practice PAGroup PAC ID 6901985688, 5 clinicians

Practice addresses (Care Compare)

600 S Church St
Hertford, NC 27944-1205
Phone (252) 368-4510

Hospital & facility affiliations

  • Albemarle Home Care and Hospice Home health agency, Elizabeth City, NC, CCN 347017
  • Gentiva Health Services Home health agency, Washington, NC, CCN 347329
  • Sentara Albemarle Medical Center Hospital, Elizabeth City, NC, CCN 340109

National Provider Directory

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

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1750111373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S CHURCH ST",
            "city": "HERTFORD",
            "state": "NC",
            "postal_code": "279441205",
            "telephone_number": "715-307-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S CHURCH ST",
            "city": "HERTFORD",
            "state": "NC",
            "postal_code": "279441205",
            "telephone_number": "252-426-5711",
            "fax_number": "252-426-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNE",
        "first_name": "TESSA",
        "middle_name": "JEANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hertford, NC

Sources for this page

Verify at the official NPI Registry.