Individual provider Active NPI

Taylor Jernigan, PA

  • Physician Assistant
  • Greenville, NC
National Provider Identifier
1871489120
Registry record updated Jun 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2101 W Arlington Blvd # 110
Greenville, NC 27834-5758
Phone
(252) 562-8502
NPI assigned
Jun 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X NC Primary

Addresses

Primary practice location

2101 W Arlington Blvd # 110
Greenville, NC 27834-5758

Mailing address

211 Rachel Dr
Elizabeth City, NC 27909-8426
Phone (252) 562-8502

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251203004346 NC Practitioner - Physician Assistant 6608369095 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Radiologists IncGroup PAC ID 2466355383, 92 clinicians

Practice addresses (Care Compare)

2101 W Arlington Blvd
Suite 210
Greenville, NC 27834-5758
Phone (252) 752-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Radiologists Inc Multi-Specialty CurrentSince Oct 1, 2025 Accepting new patients
East Carolina University CurrentSince Dec 8, 2025 Accepting new patients
East Carolina University Multi-Specialty CurrentSince Nov 6, 2025 Accepting new patients

Locations

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

2101 W Arlington Blvd
#110
Greenville, NC 27834
Phone (252) 562-8502

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

2101 W Arlington Blvd
Ste 210
Greenville, NC 27834
Phone (252) 931-7638

402 Bowman Gray Dr
Greenville, NC 27834
Phone (252) 744-9490

630 E 11th St
Washington, NC 27889
Phone (252) 946-2137

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1749859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749859200000",
    "number": "1871489120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 RACHEL DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279098426",
            "telephone_number": "252-562-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 W ARLINGTON BLVD # 110",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345758",
            "telephone_number": "252-562-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNIGAN",
        "first_name": "TAYLOR",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-14",
        "last_updated": "2025-06-14",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.