KIP PHILLIPS JENNINGS (NPI# 1871629279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871629279 |
| Entity Type | Individual |
| Full Name | KIP PHILLIPS JENNINGS |
| Credential | MPA-C |
| Practice Address |
103 Cox Blvd Goldsboro NC 27534-9478 |
| Mailing Address |
1218 Newton Dr Goldsboro NC 27534-2332 |
| Practice Telephone | 9197348440 |
| Practice Fax Number | 9197349387 |
| Mailing Telephone | 9199229865 |
| Mailing Fax Number | 9197349387 |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2012-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 1481 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0010-03163 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
103 COX BLVD |
| City | GOLDSBORO |
| State | NC |
| Zip Code | 27534-9478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184618837 | Terry Lee Forrest | Ophthalmology | 103 Cox Blvd, Goldsboro, NC 27534-9478 | 2005-09-08 |
| 1366809642 | Allison Rose Radford | Physician Assistant | 103 Cox Blvd, Goldsboro, NC 27534-9478 | 2016-01-18 |
| 1083059497 | Jennifer Faye Jordan | Ophthalmology | 103 Cox Blvd, Goldsboro, NC 27534-9478 | 2013-04-30 |
| 1124083167 | Waynesborough Ophthalmology, P.a. | Optometrist | 103 Cox Blvd, Goldsboro, NC 27534-9478 | 2006-04-20 |
| 1609860261 | Robert Grier Harding | Optometrist | 103 Cox Blvd, Goldsboro, NC 27534-9478 | 2005-09-09 |
| 1598759235 | Barry Hoyle Teasley | Ophthalmology | 103 Cox Blvd, Goldsboro, NC 27534-9478 | 2005-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457875767 | Trent Jonathan Forshey | Physical Therapist | 2126 Wayne Memorial Dr, Goldsboro, NC 27534 | 2017-07-28 |
| 1336685551 | Wayne Al Holdings, LLC | Assisted Living Facility | 901 West New Hope Rd, Goldsboro, NC 27534 | 2017-01-11 |
| 1952845471 | Latoya Faulk | Social Worker | 121 Carolina Forest Drive, Goldsboro, NC 27534 | 2016-12-19 |
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1528490604 | Eric Christian Bourgeois | Physical Therapist | 1101a Gracie Pl, Goldsboro, NC 27534 | 2013-07-31 |
| 1831439165 | Erica Nicole Davis | Optometrist | 20/20 Vision Center 625 North Berkeley Blvd, Suite D, Goldsboro, NC 27534 | 2013-02-23 |
| 1891039236 | Betty Webb Zimmerman | Nurse Practitioner | 204 Cox Blvd, Goldsboro, NC 27534 | 2012-11-26 |
| 1144595265 | Life Recovery Psychological Services | Counselor | 1202-c Wayne Memorial Dr, Goldsboro, NC 27534 | 2012-03-22 |
| 1558596536 | Taylor Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 802 Taylor St, Goldsboro, NC 27534 | 2009-05-20 |
| 1780895136 | Sherrie Fennell Edwards | Dietitian, Registered | 1500 Lanely Ave., Seymour Johnson Afb, Golsboro, NC 27534 | 2007-05-25 |
| Find all providers in zip 27534 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801923016 | Vanessa Miller Stovall | Physician Assistant | 701 Stevens Mill Rd, Goldsboro, NC 27530 | 2007-02-27 |
| 1467593830 | Rosemary Eileen Kelley | Physician Assistant | 100 S James St, Goldsboro, NC 27530-4758 | 2007-02-09 |
| 1134204670 | Glenn Williams | Physician Assistant | 202 Millbrook Village Dr, Goldsboro, NC 27530-7768 | 2006-10-25 |
| 1427416502 | Hannah Mckenzie | Physician Assistant | 212 N Spence Ave, Goldsboro, NC 27534-4318 | 2016-02-04 |
| 1366809642 | Allison Rose Radford | Physician Assistant | 103 Cox Blvd, Goldsboro, NC 27534-9478 | 2016-01-18 |
| 1184047912 | Michael Albright | Physician Assistant | 2701 Medical Office Pl, Goldsboro, NC 27534-9458 | 2014-01-30 |
| 1770822348 | Peter Malcolm Stanford | Physician Assistant | 316 Railroad Ave, Goldsboro, MD 21636-1126 | 2013-02-02 |
| 1093091910 | Tiffani Ann Hoefer | Physician Assistant | 1208 Parkway Dr Ste C, Goldsboro, NC 27534-9432 | 2011-10-24 |
| 1417253204 | Robin Lear Dawson | Physician Assistant | 2808 Mclamb Pl, Goldsboro, NC 27534-1600 | 2011-01-27 |
| 1104071034 | Ashley Blaire Slate | Physician Assistant | 2700 Wayne Memorial Dr, Emergency Dept, Goldsboro, NC 27534-9494 | 2008-11-19 |
| Find all providers in GOLDSBORO | ||||
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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.