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Individual provider Active NPI

Jessica Jelapon Yaemmongkol, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1912668419
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12625 Issued in NC
Practice address
6324 Fairview Rd Ste 420
Charlotte, NC 28210-3372
Phone
(704) 316-1120
NPI assigned
Jan 6, 2022
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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 0010-12625 NC Primary
Surgical Physician Assistant 363AS0400X 0010-12625 NC

Addresses

Primary practice location

6324 Fairview Rd Ste 420
Charlotte, NC 28210-3372

Mailing address

PO Box 604136
Charlotte, NC 28260-4136

Other practice location 1

7930 Skyland Ridge Pkwy Ste 203
Raleigh, NC 27617-6813
Phone (919) 881-8295

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
I20230112001261 NC Practitioner - Physician Assistant 0345610101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Campbell Univ School of Osteopathic Medicine, 2022
Medicare assignment
May accept Medicare assignment
Group practices
NMG Health Services LLCGroup PAC ID 4789057753, 40 clinicians
Wound Care NC, PLLCGroup PAC ID 8123208436, 3 clinicians

Practice addresses (Care Compare)

6324 Fairview Rd
Suite 420
Charlotte, NC 28210-3372
Phone (704) 316-1120

6331 Carmel Rd
Suite 102
Charlotte, NC 28226-8286
Phone (704) 316-2557

7930 Skyland Ridge Pkwy
Suite 203
Raleigh, NC 27617-6813
Phone (919) 881-8295

8201 Healthcare Loop
Suite 202
Charlotte, NC 28215-7072
Phone (704) 316-1120

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-12625NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
NMG Health Services, LLC CurrentSince Dec 19, 2025 Accepting new patients
Raleigh Emergency Surgical, Inc CurrentSince Nov 17, 2024 Accepting new patients
NMG Health Services, LLC CurrentSince Dec 19, 2025 Accepting new patients

Locations

6324 Fairview Rd
Ste 420
Charlotte, NC 28210
Phone (704) 316-1120

6331 Carmel Rd
Ste 102
Charlotte, NC 28226
Phone (704) 316-2354

7930 Skyland Ridge Pkwy
Ste 203
Raleigh, NC 27617
Phone (919) 881-8295

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1912668419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604136",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 FAIRVIEW RD STE 420",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103372",
            "telephone_number": "704-316-1120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7930 Skyland Ridge Pkwy Ste 203",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276176813",
            "country_code": "US",
            "telephone_number": "919-881-8295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAEMMONGKOL",
        "first_name": "JESSICA",
        "middle_name": "JELAPON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12625",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-12625",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.