- Medicare in Jacksonville, NC

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is a medicare enrolled "Clinic/center - Public Health, State Or Local" provider in Jacksonville, North Carolina. Their current practice location is 612 College St, Jacksonville, North Carolina. You can reach out to their office (for appointments etc.) via phone at (910) 347-2154.

is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1982743928.

Contact Information

612 College St,
Jacksonville, NC 28540-5311
(910) 347-2154
(910) 347-3166

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityClinic/center - Public Health, State Or Local
Location612 College St, Jacksonville, North Carolina
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1982743928
  • Provider Enumeration Date: 02/06/2007
  • Last Update Date: 10/29/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 1355249343
  • Enrollment ID: O20031229000841

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1982743928NPI-NPPES
07172OtherBLUE CROSS BLUE SHIELD
3404367MedicaidNC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
133V00000XDietitian, Registered (* (Not Available))Secondary
251B00000XCase Management (* (Not Available))Secondary
261QC1500XClinic/center - Community Health (* (Not Available))Secondary
261QF0050XClinic/center - Family Planning, Non-surgical (* (Not Available))Secondary
261QM2500XClinic/center - Medical Specialty (* (Not Available))Secondary
261QP0905XClinic/center - Public Health, State Or Local (* (Not Available))Primary
261QP2300XClinic/center - Primary Care (* (Not Available))Secondary
291U00000XClinical Medical Laboratory 34D0989962 (North Carolina)Secondary
291U00000XClinical Medical Laboratory 34D0865177 (North Carolina)Secondary
3336C0002XPharmacy - Clinic Pharmacy 04173 (North Carolina)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:
Provider NameTroy J Ehrhart
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1003913021
PECOS PAC ID: 3476448994
Enrollment ID: I20040216000294
Provider NameAisha R Ford
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1073044202
PECOS PAC ID: 0446528673
Enrollment ID: I20170613000298
Provider NameHaley Renae Lockwood
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1699239814
PECOS PAC ID: 5193053098
Enrollment ID: I20190829002213
Provider NamePaula Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1063024677
PECOS PAC ID: 9234537697
Enrollment ID: I20211015000347
Provider NameHaley Shedd
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316518004
PECOS PAC ID: 6002357985
Enrollment ID: I20240918003710
Provider NameShirley Campbell Nunez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386800449
PECOS PAC ID: 3173055787
Enrollment ID: I20241021000124

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

328 New Bridge St,
Jacksonville, NC 28540-4756

Ph: (910) 455-3404
612 College St,
Jacksonville, NC 28540-5311

Ph: (910) 347-2154

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.