JOHN ILLSLEY (NPI# 1598291163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598291163 |
| Entity Type | Individual |
| Full Name | JOHN ILLSLEY |
| Other Name | JOHN ILLSLEY |
| Credential | PA-C |
| Practice Address |
702 N Main St Roxboro NC 27573-4755 |
| Practice Telephone | 3365999271 |
| Practice Fax Number | 3365999271 |
| Mailing Telephone | 5613500241 |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2020-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-07223 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1598291163 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1021 Darrington Dr Ste 201, Cary, NC 275138157 | 9193547077 | 9193547075 |
| Street Address |
702 N MAIN ST |
| City | ROXBORO |
| State | NC |
| Zip Code | 27573-4755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104478882 | Kaitlyn Kirby Lytle | Physician Assistant | 702 N Main St, Roxboro, NC 27573-4755 | 2019-07-12 |
| 1487219879 | Mary Elizabeth Matthews | Physician Assistant | 702 N Main St, Roxboro, NC 27573-4755 | 2019-05-01 |
| 1780160135 | Quinn Demott | Nurse Practitioner | 702 N Main St, Roxboro, NC 27573-4755 | 2018-07-18 |
| 1639609415 | Jessica Anne Cooper | Social Worker | 702 N Main St, Roxboro, NC 27573-4755 | 2017-06-14 |
| 1609263599 | Alisa Paliy | Psychiatry & Neurology | 702 N Main St, Roxboro, NC 27573-4755 | 2015-04-19 |
| 1275948804 | Rivkah Krevsky | Dentist | 702 N Main St, Roxboro, NC 27573-4755 | 2014-06-23 |
| 1811239288 | Aileen V Searles | Pediatrics | 702 N Main St, Roxboro, NC 27573-4755 | 2013-03-22 |
| 1881948339 | Angela J Good | Nurse Practitioner | 702 N Main St, Roxboro, NC 27573-4755 | 2012-11-06 |
| 1568726610 | Stephanie George | Dentist | 702 N Main St, Roxboro, NC 27573-4755 | 2012-07-03 |
| 1114218492 | Demaura H Russell | Family Medicine | 702 N Main St, Roxboro, NC 27573-4755 | 2011-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043786783 | Caitlin Elissa Seidler | Physician Assistant | 910 N Madison Blvd Ste B, Roxboro, NC 27573 | 2018-10-21 |
| 1467821801 | Iris W Jackola | Nurse Practitioner | 796 Doctor's Court, Roxboro, NC 27573 | 2015-09-16 |
| 1568897213 | Person County Group Homes, Inc. | Community/Behavioral Health | 607 Henry Street, Roxboro, NC 27573 | 2013-09-12 |
| 1760820336 | J-1 Consultants LLC | Psychologist | 315 Old Allensville Road, Roxboro, NC 27573 | 2013-06-05 |
| 1932445749 | Ronnie Lee Chandler | Pharmacist | 109 North Main St., Roxboro, NC 27573 | 2012-12-26 |
| 1154559581 | Roxboro Medaccess Primary Care | Clinic/Center | 3762 Durham Road, Roxboro, NC 27573 | 2009-06-24 |
| 1699922302 | Bruce Wayne Walsh | Counselor | 355 C1 S. Madison Blvd, Roxboro, NC 27573 | 2008-08-25 |
| 1033232020 | Person County Department of Social Services | Durable Medical Equipment & Medical Supplies | 355-b South Madison Blvd, Roxboro, NC 27573 | 2007-04-06 |
| 1417095886 | Thomas Jones Day Jr. | Dentist | 407 North Main St, Roxboro, NC 27573 | 2007-02-01 |
| 1578622288 | Corey Wayne Wilson | Dentist | 112 West Barden Street, Roxboro, NC 27573 | 2006-12-08 |
| Find all providers in zip 27573 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891757498 | Miguel A Pineiro | Physician Assistant | 228 S Madison Blvd, Roxboro, NC 27573-5428 | 2006-04-06 |
| 1699372466 | Anna Frances Stephenson | Physician Assistant | 107 Weeks Dr, Roxboro, NC 27573-3929 | 2020-10-05 |
| 1831722503 | Nadine Kundimana Minani | Physician Assistant | 615 Ridge Rd, Roxboro, NC 27573-4629 | 2020-02-20 |
| 1841841673 | Ashley Ann Welch | Physician Assistant | 609 Professional Dr, Roxboro, NC 27573-4543 | 2019-09-23 |
| 1104478882 | Kaitlyn Kirby Lytle | Physician Assistant | 702 N Main St, Roxboro, NC 27573-4755 | 2019-07-12 |
| 1487219879 | Mary Elizabeth Matthews | Physician Assistant | 702 N Main St, Roxboro, NC 27573-4755 | 2019-05-01 |
| 1821591215 | Richard Gerald Cowan Jr. | Physician Assistant | 799 Doctors Ct, Roxboro, NC 27573-4571 | 2018-03-13 |
| 1649719014 | Jason Prater | Physician Assistant | 615 Ridge Rd, Roxboro, NC 27573-4629 | 2017-02-18 |
| 1972041804 | Paige Davenport Myers | Physician Assistant | 910 N Madison Blvd, Roxboro, NC 27573-0040 | 2017-02-12 |
| 1255755740 | Peter W. Hawkins | Physician Assistant | 3762 Durham Rd Ste A, Roxboro, NC 27573-2741 | 2014-02-05 |
| Find all providers in ROXBORO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.