Jessica S Provo (NPI# 1699121368, PAC ID# 8123312931) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1699121368 |
| PAC ID by PECOS | 8123312931 |
| Professional Enrollment ID | I20190813001163 |
| Full Name | Jessica S Provo |
| Organization Legal Name | CAROLINA HEALTHCARE ASSOCIATES INC |
| Address |
1333 S Dickinson Dr Suite 240 Leland NC 28451-6434 |
| Phone Number | 9103320241 |
| Gender | F |
| Medical School | TULANE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2015 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6204805823 |
| Number of Group Practice Members | 233 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340141 | NEW HANOVER REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1333 S Dickinson Dr, Suite 240, Leland, NC 28451-6434 | 9103320241 | CAROLINA HEALTHCARE ASSOCIATES INC |
| Organization Legal Name | CAROLINA HEALTHCARE ASSOCIATES INC |
| Physicians | 238 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephanie C Holt | Internal Medicine | Carolina Healthcare Associates Inc | 5145 S College Rd, Wilmington, NC 28412-2207 |
| Walker J Jamar | Physician Assistant | Carolina Healthcare Associates Inc | 1520 Physicians Dr, Wilmington, NC 28401-7356 |
| Beverly Montalvo | Nurse Practitioner | Carolina Healthcare Associates Inc | 584 Hospital Dr E, Cape Fear Heart Assoictes, Bolivia, NC 28422-9047 |
| Darshan D Dave | Internal Medicine | Carolina Healthcare Associates Inc | 7420 Market St, Wilmington, NC 28411-9453 |
| George T Newbill | Family Medicine | Carolina Healthcare Associates Inc | 7910 Us Hwy 117 S, Unit 120, Rocky Point, NC 28457-7409 |
| Kimberly R Brunsink | Family Medicine | Carolina Healthcare Associates Inc | 1960 S 16th St, Wilmington, NC 28401-6676 |
| Carli Williams | Family Medicine | Carolina Healthcare Associates Inc | 306 S Campbell St, Burgaw, NC 28425-5010 |
| Esther Rochelle Murray | Physician Assistant | Carolina Healthcare Associates Inc | 1509 Doctors Cir C, Wilmington, NC 28401-7403 |
| Marcus Richard Bair | Physical Therapy | Carolina Healthcare Associates Inc | 2710 Market St, Wilmington, NC 28403-1218 |
| Bridgette E Williams | Nurse Practitioner | Carolina Healthcare Associates Inc | 1415 Physicians Dr, Wilmington, NC 28401-7338 |
| Street Address |
1333 S DICKINSON DR SUITE 240 |
| City | LELAND |
| State | NC |
| Zip | 28451-6434 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Latessa S Spiers | Internal Medicine | Carolina Healthcare Associates Inc | 1333 S Dickinson Dr, Suite 240, Leland, NC 28451-6434 |
| Jane Beebe Kehaya | Obstetrics/gynecology | Carolina Healthcare Associates Inc | 1333 S Dickinson Dr, Suite 110, Leland, NC 28451-6434 |
| Linda S Bombach | Nurse Practitioner | Carolina Healthcare Associates Inc | 1333 S Dickinson Dr, Suite 240, Leland, NC 28451-6434 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennah Cutting | Nurse Practitioner | Moore Medical Group Inc | 2050 Mercantile Dr, Leland, NC 28451-4053 |
| Benjamin Donaldson | Physician Assistant | 2050 Mercantile Dr, Suite C9, Leland, NC 28451-4053 | |
| Linda Joyce Cooper | Clinical Social Worker | 1008 Little Egret Run, Leland, NC 28451-4108 | |
| Catherine M Furlani | Nurse Practitioner | Carolina Healthcare Associates Inc | 509 Olde Waterford Way, Leland, NC 28451-4125 |
| Justin E Asbury | Family Medicine | Novant Medical Group Inc | 509 Olde Waterford Way, Suite 200, Leland, NC 28451-4126 |
| Tori Asbury | Family Medicine | Novant Medical Group Inc | 509 Olde Waterford Way, Suite 200, Leland, NC 28451-4126 |
| Christopher P Rizzo | Chiropractic | Rizzo Enterprises Inc | 509 Olde Waterford Way, Suite 201, Leland, NC 28451-4126 |
| Joana A Carnahan | Family Medicine | Novant Medical Group Inc | 509 Olde Waterford Way, Suite 200, Leland, NC 28451-4126 |
| Steven J Maniscalco | Chiropractic | Rizzo Enterprises Inc | 509 Olde Waterford Way, Suite 201, Leland, NC 28451-4126 |
| Lysa B Long | Certified Nurse Midwife (cnm) | Novant Medical Group Inc | 509 Olde Waterford Way, Suite 204, Leland, NC 28451-4126 |
| Find all physicians in zip 28451 | |||
| City | LELAND |
| Zip Code | 28451 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | LELAND + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Jessica S Provo.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.