Provider Demographics
NPI:1386679025
Name:MOREHART, JODI ANN (PA)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:ANN
Last Name:MOREHART
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7008
Mailing Address - Country:US
Mailing Address - Phone:336-802-2400
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:375 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5611
Practice Address - Country:US
Practice Address - Phone:336-625-4215
Practice Address - Fax:336-626-0919
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC101335363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC23315OtherMEDCOST
S90691Medicare UPIN
NC23315OtherMEDCOST