Provider Demographics
NPI:1720278500
Name:HOFF, JEREMY JAY (DO)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:JAY
Last Name:HOFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 ASHTON DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2489
Mailing Address - Country:US
Mailing Address - Phone:910-332-3800
Mailing Address - Fax:910-251-0421
Practice Address - Street 1:2716 ASHTON DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412
Practice Address - Country:US
Practice Address - Phone:910-332-3800
Practice Address - Fax:910-251-0421
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202405208VP0014X, 208100000X
NC2018-01336208VP0014X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1720278500OtherSENTARA HEALTH PLANS
VA1720278500OtherCOVENTRY/MAILHANDLERS
VA2329969OtherCIGNA
VA541869550OtherTRICARE
VA1720278500OtherBLUE CROSS BLUE SHIELD
VA1720278500OtherMAMSI/UHC
VA1720278500OtherAETNA
VA1720278500Medicaid
VA1720278500OtherCOVENTRY/MAILHANDLERS