Individual provider Active NPI

Jonathan Douglas Garrett, PA-C

  • Physician Assistant
  • Statesville, NC
National Provider Identifier
1992745400
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103930 Issued in NC
Practice address
633 Brookdale Dr Ste 300
Statesville, NC 28677-3471
Phone
(704) 873-3250
Fax
(704) 873-2940
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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 103930 NC Primary

Addresses

Primary practice location

633 Brookdale Dr Ste 300
Statesville, NC 28677-3471

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 873-4277

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
I20040121000918 NC Practitioner - Physician Assistant 7810899846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iredell Physician Network LLCGroup PAC ID 0749345007, 91 clinicians

Practice addresses (Care Compare)

Statesville, NC 28677
Phone (704) 838-2182

515 Brookdale Dr
Statesville, NC 28677-4107
Phone (704) 380-3620

544 Brawley School Rd
Mooresville, NC 28117-9393

557 Brookdale Dr
Statesville, NC 28677-4107
Phone (704) 873-5661

766 Hartness Rd
Suite B
Statesville, NC 28677-3479

770 Hartness Rd
Statesville, NC 28677-3376
Phone (704) 883-3378

774 Hartness Rd
Statesville, NC 28677-3376
Phone (704) 768-3030

Hospital & facility affiliations

  • Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iredell Physician Network LLC CurrentSince Aug 14, 2024 Accepting new patients
Iredell Physician Network LLC CurrentSince Aug 14, 2024 Accepting new patients

Locations

544 Brawley School Rd
Ste C
Mooresville, NC 28117
Phone (704) 360-9299

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

774 Hartness Rd
Statesville, NC 28677
Phone (704) 768-3030

1668 NC Highway 16 S
Taylorsville, NC 28681
Phone (828) 632-9736

Organizations & group practices 3

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 1

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1992745400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277",
            "fax_number": "704-873-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 BROOKDALE DR STE 300",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773471",
            "telephone_number": "704-873-3250",
            "fax_number": "704-873-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "JONATHAN",
        "middle_name": "DOUGLAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.