NPIMap

Organization Active NPI

Dr. Jernigan and Associates, P.a.

  • General Practice Dentistry
  • Rocky Mount, NC
National Provider Identifier
1831174028
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4913 Issued in NC
Legal business name
DR. JERNIGAN AND ASSOCIATES, P.A.
Practice address
1427 N Wesleyan Blvd
Rocky Mount, NC 27804-1843
Phone
(252) 977-7197
Fax
(252) 977-7403
NPI assigned
Dec 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Dr. Edward Williams Jernigan Jr., DDSNPI 1174550339
Title
President
Phone
(252) 977-7197

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 4913 NC Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 5140 NC

Addresses

Primary practice location

1427 N Wesleyan Blvd
Rocky Mount, NC 27804-1843

Mailing address

1427 N Wesleyan Blvd
Rocky Mount, NC 27804
Phone (252) 977-7197

Other identifiers 4

IdentifierTypeStateIssuer
5140OtherNCDR DAVIS DENTAL LICENSE
8992091MedicaidNC
4913OtherNCDR JERNIGAN DENTAL LIC#
8994578MedicaidNC

Other names 1

  • Drs. Jernigan, Davis and Associates, PA Former legal business name

National Provider Directory

National Provider Directory

Locations

1427 N Wesleyan Blvd
Rocky Mount, NC 27804
Phone (252) 977-7197

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1831174028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 N WESLEYAN BLVD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "27804",
            "telephone_number": "252-977-7197",
            "fax_number": "252-977-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 N WESLEYAN BLVD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278041843",
            "telephone_number": "252-977-7197",
            "fax_number": "252-977-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JERNIGAN AND ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "JERNIGAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "WILLIAMS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-977-7197",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "4913",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR DAVIS DENTAL LICENSE",
            "identifier": "5140",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8992091",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR JERNIGAN DENTAL LIC#",
            "identifier": "4913",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8994578",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs. Jernigan, Davis and Associates, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.