NPIMap

Individual provider Active NPI

Jacqueline Huff, PA-C

  • Physician Assistant
  • Kernersville, NC
National Provider Identifier
1871884049
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07937 Issued in NC
Practice address
111 Gateway Center Dr
Kernersville, NC 27284-2999
Phone
(336) 852-2550
Fax
(336) 294-2851
NPI assigned
Apr 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07937 NC Primary

Addresses

Primary practice location

111 Gateway Center Dr
Kernersville, NC 27284-2999

Mailing address

1060 Longreen Dr
Kernersville, NC 27284-8162
Phone (606) 471-4266

Other names 1

  • Jackie Huff Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200720003675 NC Practitioner - Physician Assistant 0547446932 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-07937NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Health Network, LLC CurrentSince May 10, 2021 Accepting new patients
Wake Forest University Health Sciences CurrentSince May 10, 2021 Accepting new patients
Cornerstone Health Care LLC CurrentSince May 10, 2021 Accepting new patients

Locations

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

111 Gateway Center Dr
Kernersville, NC 27284
Phone (336) 996-2173

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: jhuff2755265@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1871884049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 LONGREEN DR",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272848162",
            "telephone_number": "606-471-4266",
            "fax_number": "336-294-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GATEWAY CENTER DR",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842999",
            "telephone_number": "336-852-2550",
            "fax_number": "336-294-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFF",
        "first_name": "JACQUELINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-22",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "HUFF",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.