Jennifer Martine Pasternack, MD
Individual provider Active NPI Psychiatry Physician · Mill Spring, NC
NPI 1831269505 · NPPES record last updated Jul 13, 2015
Key facts
- NPI
- 1831269505
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 2014-00045 (NC)
- Practice address
- 101 Healing Farm LN
Mill Spring, NC 28756-5808 - Phone
- (828) 894-5557
- Fax
- (828) 894-7120
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 18, 2016 through Apr 18, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014-00045 | NC | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Beacon Group LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2014-00045 | NC | Yes |
Addresses
Primary practice location
101 Healing Farm LN
Mill Spring, NC 28756-5808
Mailing address
101 Healing Farm LN
Mill Spring, NC 28756-5808
Phone (828) 894-5557
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00026958401 | Other | NY | UNIVERA |
| 716205 | Other | PA | HIGHMARK BLUE SHIELD |
| 260050172 | Other | PA | RAILROAD MEDICARE |
| 001684240 | Medicaid | PA | |
| 00530729 | Medicaid | NC |
Other providers in Mill Spring, NC
- Marilyn Malcolm
- Thomas Wylie McDonald
- New Horizon Wellness Counseling PLLC
- Colden O'Dell
- Lynne Parsons
- Pavillon International
- Pavillon International
- Pavillon Outpatient Services
- Physical Rehab Services
- Sabol Anesthesia
All providers in Mill Spring, NC · Psychiatry Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.