Jacquelyn Dwelle McGinnis, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5012332 Issued in NC

Practice address

400 E Statesville Ave Ste 200
Mooresville, NC 28115-2588

Phone

(704) 360-8486

Fax

(704) 230-4674

NPI assigned

Oct 1, 2019

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16389/brand/1/csg/1/fhir/r4

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.

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272
  Medicare reassignment NPD
• Southern Family Medicine, Inc.

  • Community/Behavioral Health Agency
  • Mooresville, NC
  • NPI 1881144590
  Medicare reassignment NPD
• Caromont Medical Group Inc

  • Psychiatry Physician
  • Gastonia, NC
  • NPI 1629197744
  NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1750922779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-865-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E STATESVILLE AVE STE 200",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152588",
            "telephone_number": "704-360-8486",
            "fax_number": "704-230-4674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1337 E Garrison Blvd",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "28054",
            "country_code": "US",
            "telephone_number": "704-865-3848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGINNIS",
        "first_name": "JACQUELYN",
        "middle_name": "DWELLE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5012332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacie McDade, BCBA
• Fayla Marie McDaniel
• Leann Presley McDevitt, OTR/L
• James Patrick McDonald, MD
• Irene McDonnell, MA CCC SLP
• Virginia Bess McGinnis, MS, OTRL
• Lindsay McGlamery-Hartsell, PT
• Shea Margaret McGovern
• Megan Kaitlin McGugan
• John Lyle McGuinness

• Psychiatric/Mental Health Nurse Practitioner in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.