Jesse Enterline Baccus

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5020391 Issued in NC

Practice address

100 Medical Dr
Elizabeth City, NC 27909-3361

Phone

(252) 384-2600

NPI assigned

Aug 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Albemarle Physician Services - Sentara IncGroup PAC ID 8729139852, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Home Care Services Home health agency, Elizabeth City, NC, CCN 347202
• Sentara Albemarle Medical Center Hospital, Elizabeth City, NC, CCN 340109

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Albemarle Physician Services - Sentara, Inc

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1942443130

  NC

  Medicare reassignment Care Compare group NPD
• Albemarle Physician Services - Sentara, Inc

  • Urgent Care Clinic/Center
  • Kitty Hawk, NC
  • NPI 1306202627
  NPD

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

• Sentara Albemarle Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth City, NC
  • NPI 1245211168

  Hospital

  Care Compare affiliation
• Sentara Enterprises

  • Home Health Agency
  • Elizabeth City, NC
  • NPI 1992745343
  Care Compare affiliation

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1760101646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MOYE BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278344300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093361",
            "telephone_number": "252-384-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Moye Blvd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278344300",
            "country_code": "US",
            "telephone_number": "252-744-6478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACCUS",
        "first_name": "JESSE",
        "middle_name": "ENTERLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5020391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cheryl Overton Baker, PHARMD
• Jason Andrew Banks, DDS
• Marie Annette Banks, AA. HHA,

• All providers in Elizabeth City, NC
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.
• 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.