Individual provider Active NPI

Jaclyn Lea Adkins, PA

  • Physician Assistant
  • Rainelle, WV
National Provider Identifier
1750419966
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00866 Issued in WV
Practice address
645 Kanawha Ave
Rainelle, WV 25962-1013
Phone
(304) 438-6188
Fax
(304) 438-6819
NPI assigned
Mar 1, 2007
Last updated
Jul 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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 00866 WV Primary

Addresses

Primary practice location

645 Kanawha Ave
Rainelle, WV 25962-1013

Mailing address

HC 30 Box 56
Caldwell, WV 24925
Phone (304) 645-1463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20200414000040 VA Practitioner - Physician Assistant 7416009311 Reassigns benefits to 3 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
Alliance Xpress Care LLCGroup PAC ID 5496063091, 16 clinicians

Practice addresses (Care Compare)

5275 Alexander Rd
Suite a
Dublin, VA 24084-3657
Phone (540) 960-2231

919 S Craig Ave
Suite a
Covington, VA 24426-1954
Phone (540) 960-2231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
364WVMDPsychologist
00866WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Murray E Joiner Jr MD PC Physician Assistant CurrentSince May 1, 2020 Accepting new patients
Murray E Joiner Jr MD PC CurrentSince May 1, 2020 Accepting new patients
Wvva Health Care Alliance, PC Past Accepting new patients
Regional Family Medicine, Inc Past Accepting new patients

Locations

1945 Thomson Dr
Lynchburg, VA 24501
Phone (434) 845-6664

2726 Electric Rd
Ste 203
Roanoke, VA 24018
Phone (540) 772-4448

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1750419966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 30 BOX 56",
            "city": "CALDWELL",
            "state": "WV",
            "postal_code": "24925",
            "telephone_number": "304-645-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 KANAWHA AVE",
            "city": "RAINELLE",
            "state": "WV",
            "postal_code": "259621013",
            "telephone_number": "304-438-6188",
            "fax_number": "304-438-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADKINS",
        "first_name": "JACLYN",
        "middle_name": "LEA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "00866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rainelle, WV

Sources for this page

Verify at the official NPI Registry.