Jennifer Lynn Petrone, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-11308 Issued in NC

Practice address

12701 US Highway 70W Business
Clayton, NC 27520-2195

Phone

(919) 235-1968

Fax

(919) 235-1307

NPI assigned

Oct 1, 2021

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

Physician Assistant

Education

Wake Forest University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Wake Specialty Physicians, LLC

  • Surgery Physician
  • Raleigh, NC
  • NPI 1942440375

  Physician Assistant

  Medicare reassignment Care Compare group NPD (past)
• Wake Specialty Physicians LLC

  dba WakeMed Primary Care Cambridge Apex

  • Family Medicine Physician
  • Apex, NC
  • NPI 1609511765
  NPD
• Wake Specialty Physicians LLC

  dba WakeMed MyCare 365 Primary & Urgent Care Morrisville

  • Family Medicine Physician
  • Morrisville, NC
  • NPI 1174491138
  NPD (past)
• Wake Specialty Physicians LLC

  dba WakeMed MyCare 365 Primary & Urgent Care Clayton

  • Family Medicine Physician
  • Clayton, NC
  • NPI 1841881919
  NPD (past)

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

• Wakemed

  dba WakeMed Mental Health & Well-Being Hospital WakeBrook

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302
  Care Compare affiliation
• Wakemed

  dba WakeMed Raleigh Campus

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1972579837
  Care Compare affiliation

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1841962420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "877-498-4490",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 US HIGHWAY 70W BUSINESS",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202195",
            "telephone_number": "919-235-1968",
            "fax_number": "919-235-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRONE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11308",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-11308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peniel House, LLC
• Lave Wilson Pennywell
• People Living in All Communities
• Joan Yolanda Perez
• Cameron Luther Perkins, PA
• Tiana Angeline Petrone
• Alexis Phelps
• Jessica Phillips
• Jessica Phillips, APRN
• Regina Oakley Phillips, LPC

• Medical Physician Assistant in Clayton, NC
• Providers in Clayton, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.