Jaclyn Marie Bissell, PA-C
Physician Assistant in Greensboro, NC. Individual provider (NPI-1).
NPI number1184875171
StatusActive
Last updated in NPPESDec 6, 2013
Details
- NPI
- 1184875171
- Entity type
- Individual (NPI-1)
- Name
- Jaclyn Marie Bissell
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 8, 2008
- Last updated
- Dec 6, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 0010-04181 | NC | Yes |
Practice location
3200 Northline AvenueSte 200
Greensboro, NC 27408-7602
Phone 336-545-5000 · Fax 336-545-5020
Mailing address
3200 Northline AvenueSte 200
Greensboro, NC 27408-7602
Phone 336-545-5000 · Fax 336-545-5020
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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