NPIMap

Individual provider Active NPI

Julienne Annette Summerlin, PA

  • Physician Assistant
  • Reidsville, NC
National Provider Identifier
1942228333
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
101517 Issued in NC
Practice address
621 S Main St Ste 100
Reidsville, NC 27320-5034
Phone
(336) 342-6880
NPI assigned
Jul 17, 2006
Last updated
Dec 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 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 101517 NC Primary

Addresses

Primary practice location

621 S Main St Ste 100
Reidsville, NC 27320-5034

Mailing address

621 S Main St Ste 100
Reidsville, NC 27320-5034
Phone (336) 342-6880

Other practice location 1

601 N Elm St
High Point, NC 27262-4331
Phone (336) 716-2255

Other practice location 2

1818 Richardson Dr Ste F
Reidsville, NC 27320-5450
Phone (336) 951-6160

Other names 1

  • Mrs. Julienne Summerlin Connor Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsummerlin659280@direct.conehealth.com Direct

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
I20060130000187 NC Practitioner - Physician Assistant 9638183627 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

1319 New Garden Rd
Greensboro, NC 27410-2722
Phone (336) 716-9622

1600 Highwoods Blvd
Greensboro, NC 27410-2048
Phone (743) 230-6697

1977 Cotton Grove Rd
Lexington, NC 27292-5721
Phone (336) 443-6041

2005 Pisgah Church Rd
Greensboro, NC 27455-3309
Phone (336) 701-2662

2452 Fairlawn CT
Winston Salem, NC 27106-3884
Phone (336) 281-5965

3120 Northline Ave
Greensboro, NC 27408-7814

3163 Gammon LN
Clemmons, NC 27012-9052
Phone (336) 310-5571

50 Miller St
Suite C
Winston Salem, NC 27104-4206
Phone (336) 310-5535

794 S Main St
Suite B
Kernersville, NC 27284-4074
Phone (336) 904-2317

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
101517NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Medicorp Enterprises, LLC CurrentSince Sep 3, 2022 Accepting new patients
Wake Forest University Health Sciences CurrentSince Aug 22, 2016 Accepting new patients
Moses Cone Physician Services, Inc. Physician Assistant CurrentSince Dec 4, 2022 Accepting new patients
Carolina Medicorp Enterprises, LLC CurrentSince Sep 3, 2022 Accepting new patients
Moses Cone Physician Services Inc CurrentSince Dec 4, 2022 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Jan 23, 2006 Accepting new patients
Wake Forest Health Network LLC CurrentSince Jan 23, 2006 Accepting new patients
Cornerstone Medical Center, PA Current Accepting new patients
Randolph Specialty Group Practice Past Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

1041 Kirkpatrick Rd
Ste 100
Burlington, NC 27215
Phone (336) 538-0089

9550 Rocky River Rd
Ste 150
Charlotte, NC 28215
Phone (704) 457-1510

301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200

218 Gatewood Ave
High Point, NC 27262
Phone (336) 802-2030

4590 Premier Dr
High Point, NC 27265
Phone (336) 333-6306

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

601 N Elm St
High Point, NC 27262
Phone (336) 878-6419

1814 Westchester Dr
Ste 101
High Point, NC 27262
Phone (336) 802-2105

611 N Lindsay St
Ste 200
High Point, NC 27262
Phone (336) 802-2250

621 S Main St
Ste 100
Reidsville, NC 27320
Phone (336) 342-6880

1818 Richardson Dr
Ste F
Reidsville, NC 27320
Phone (336) 342-4791

711 National Hwy
Ste 500
Thomasville, NC 27360
Phone (336) 474-1995

600 Highland Oaks Dr
Winston Salem, NC 27103
Phone (366) 774-0040

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

Interoperability endpoints

  • Direct secure messaging: jconnor792014@direct.novanthealth.org
  • Direct secure messaging: jconnor2755220@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 16

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.

View all 16

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1942228333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S MAIN ST STE 100",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205034",
            "telephone_number": "336-342-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S MAIN ST STE 100",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205034",
            "telephone_number": "336-342-6880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Elm St",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272624331",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1818 Richardson Dr Ste F",
            "address_purpose": "LOCATION",
            "city": "Reidsville",
            "state": "NC",
            "postal_code": "273205450",
            "country_code": "US",
            "telephone_number": "336-951-6160",
            "fax_number": "336-951-6171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERLIN",
        "first_name": "JULIENNE",
        "middle_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "101517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsummerlin659280@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1818 Richardson Dr Ste F",
            "city": "Reidsville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "273205450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JULIENNE",
            "last_name": "CONNOR",
            "middle_name": "SUMMERLIN",
            "prefix": "MRS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reidsville, NC

Sources for this page

Verify at the official NPI Registry.