Active NPI
Stephen Bruce Jones, PAC
- Physician Assistant
- Carolina Shores, NC
National Provider Identifier
1811966849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 103554
- Practice address
- 9869 Ocean Hwy W Ste 12
Carolina Shores, NC 28467-2636 - Phone
- (910) 754-8600
- Fax
- (910) 755-2364
- NPI assigned
- Mar 14, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 103554 | NC | Primary |
Addresses
Primary practice location
9869 Ocean Hwy W Ste 12
Carolina Shores, NC 28467-2636
Mailing address
714 Highway 17
Little River, SC 29566
Phone (843) 249-2868
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103554 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shallotte Medical Center Inc | Past | Accepting new patients | |
| Shallotte Medical Center Inc | Past | Accepting new patients | |
| Chicora Medical Group PA | Past | Accepting new patients | |
| Coastal Rehabilitation Associates | Past | Accepting new patients | |
| Ucb Properties LLC | Past | Accepting new patients |
Organizations & group practices 5
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.
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- Family Medicine Physician
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811966849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 HIGHWAY 17",
"city": "LITTLE RIVER",
"state": "SC",
"postal_code": "29566",
"telephone_number": "843-249-2868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9869 OCEAN HWY W STE 12",
"city": "CAROLINA SHORES",
"state": "NC",
"postal_code": "284672636",
"telephone_number": "910-754-8600",
"fax_number": "910-755-2364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "STEPHEN",
"middle_name": "BRUCE",
"name_prefix": "Mr.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "103554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carolina Shores, NC
- Anne Bryan Griffiths
- Richard Eugene Haire, PA-C
- Judith M Heintz, NP
- Karen E Jensen, RRT
- Shawn Paul Johnson, DO
- Level Up Physical Therapy Inc
- Ross Alden Lippard
- Novant Health Medical Group Coastal Region, LLC (NHMGCR Cancer Institute)
- Novant Health Medical Group Coastal Region, LLC (Novant Health Cancer Institute)
- Novant Health Medical Group NC Coastal Region Specialty, LLC (Novant Health Cancer Institute)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.