DR. JASON MATTHEW JERRY M.D. NPI 1023284353

NPI Information

NPI: 1023284353
Provider Name: DR. JASON MATTHEW JERRY, M.D.
Classification: Psychiatry & Neurology - 2084A0401X
Entity Type: Individual

Specialization: Addiction Medicine

Organization: MCPC-11 LLC

PECOS Registration: Yes

Address:
35 MEMORIAL DR
PINEHURST, NC
ZIP 28374
Phone: (910) 715-3376
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DR. Jason Matthew Jerry, M.D. is an addiction medicine psychiatry neurology in Pinehurst, NC with 25 years of experience. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine DR. Jason Matthew Jerry, M.D. NPI is 1023284353. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE
Graduation Year:1999

The provider's business location address is:

35 MEMORIAL DR
PINEHURST, NC
ZIP 28374-708
Phone: (910) 715-3376

The NPI 1023284353 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/6/2008 and was last updated on 5/9/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084A0401X	Psychiatry & Neurology	Addiction Medicine	2016-02570	NORTH CAROLINA	Yes
2	2084A0401X	Psychiatry & Neurology	Addiction Medicine	ME86759	FLORIDA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3065454	MEDICAID	OHIO
2	1023284353	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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