Jeffery Clifford Jarvis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1104344 Issued in NU

Practice address

2050A 2ND St SE
Kirtland AFB, NM 87117-5522

Phone

(505) 846-3200

NPI assigned

May 16, 2011

Last updated

Aug 13, 2021By the provider in NPPES

Sex

Male

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 FL

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

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlantis Urgent Care LLCGroup PAC ID 6305895111, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Atlantis Urgent Care, LLC

  dba Atlantis Urgent Care

  • Urgent Care Clinic/Center
  • Indian Harbour Beach, FL
  • NPI 1821280579
  Medicare reassignment Care Compare group

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

• Holmes Regional Medical Center, Inc.

  dba First Flight

  • Air Ambulance
  • Melbourne, FL
  • NPI 1235312281

  Hospital

  Care Compare affiliation
• Holmes Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Melbourne, FL
  • NPI 1295702728
  Care Compare affiliation

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1851684443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050A 2ND ST SE",
            "city": "KIRTLAND AFB",
            "state": "NM",
            "postal_code": "871175522",
            "telephone_number": "505-846-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050A 2ND ST SE",
            "city": "KIRTLAND AFB",
            "state": "NM",
            "postal_code": "871175522",
            "telephone_number": "505-846-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "JEFFERY",
        "middle_name": "CLIFFORD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-16",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "1104344",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel J Hohman, DO, MPH
• Bobby N Holstead, PH.D.
• James S. Ice, D.O
• Christina Jap, PHARMD
• Jarom Jardine, DO
• Stephen Antonioli Jennings, M.D.
• Lynn Michael Johnson, DDS
• Susan Joseph
• Mandy Kenyon, RD
• Maureen Forsythe Kimsey

• Physician Assistant in Kirtland AFB, NM
• Providers in Kirtland AFB, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.