Provider Demographics
NPI:1366483448
Name:SCHMIDT, JAMIE MORGAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:MORGAN
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 HEIN DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-5269
Mailing Address - Country:US
Mailing Address - Phone:813-267-1661
Mailing Address - Fax:
Practice Address - Street 1:6500 RED HOOK PLZ STE 205
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-1346
Practice Address - Country:US
Practice Address - Phone:340-775-2303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPAX00005900363AM0700X
VI76363AM0700X
FLPA9103108363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S78694Medicare UPIN
FLU4556ZMedicare ID - Type Unspecified