Individual provider Active NPI

Jessica A Wright, PA-C

  • Physician Assistant
  • Fuquay Varina, NC
National Provider Identifier
1902100134
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09610 Issued in NC
Practice address
1418 N Main St
Fuquay Varina, NC 27526-8901
Phone
(919) 552-1733
Fax
(919) 552-1495
NPI assigned
Jan 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 0010-09610 NC Primary

Addresses

Primary practice location

1418 N Main St
Fuquay Varina, NC 27526-8901

Mailing address

3500 Boston St Ste J1
Baltimore, MD 21224-5723

Other practice location 1

3500 Boston St
Suite J1
Baltimore, MD 21224-5251
Phone (410) 522-0001

Other practice location 2

4100 Wake Forest Rd
Raleigh, NC 27609-6227
Phone (373) 872-3959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130430000401 MD Practitioner - Physician Assistant 0244415883 Reassigns benefits to 1 organization
I20200512000439 NC Practitioner - Physician Assistant 0244415883 Reassigns benefits to 2 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
Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

11491 Clayton Blvd
Clayton, NC 27520-2207
Phone (919) 560-2484

11491 US 70 Business Hwy W
Clayton, NC 27520-2207
Phone (919) 550-2484

1418 N Main St
Fuquay Varina, NC 27526-8901
Phone (919) 552-1733

7010 NC Hwy 751
Durham, NC 27707-5733
Phone (919) 313-3900

Merit-based Incentive Payment System (MIPS)

Final score
74.09 of 100Reported as group
Quality
65.78
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-09610NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Physician Services of Maryland, PC Physician Assistant CurrentSince Apr 1, 2013 Accepting new patients
Matrix Occupational Health P.C. CurrentSince Mar 23, 2020 Accepting new patients
Fastmed Primary Care, P.C. Past Accepting new patients

Locations

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

1110 Kildaire Farm Rd
Cary, NC 27511
Phone (919) 481-0277

4100 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 872-3959

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.

NPI Registry JSON

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1902100134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 BOSTON ST STE J1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 N MAIN ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275268901",
            "telephone_number": "919-552-1733",
            "fax_number": "919-552-1495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Boston St",
            "address_2": "Suite J1",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212245251",
            "country_code": "US",
            "telephone_number": "410-522-0001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4100 Wake Forest Rd",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276096227",
            "country_code": "US",
            "telephone_number": "373-872-3959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-03",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

Verify at the official NPI Registry.