Jenise Victoria Bacon Menshew, PA-C
Physician Assistant in Burlington, NC. Individual provider (NPI-1).
NPI number1376563924
StatusActive
Last updated in NPPESAug 10, 2012
Details
- NPI
- 1376563924
- Entity type
- Individual (NPI-1)
- Name
- Jenise Victoria Bacon Menshew
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 19, 2006
- Last updated
- Aug 10, 2012
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 | 104189 | NC | Yes |
| 363A00000X | Physician Assistant | PA0961 | TN | |
| 363A00000X | Physician Assistant | 4331 | GA |
Practice location
1240 Huffman Mill RdBurlington, NC 27215-8700
Phone 336-538-7060
Mailing address
2020 Kildare Woods DrGreensboro, NC 27407-6370
Phone 404-556-1039
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All 91 Physician Assistant providers in Burlington · All 2,344 providers in Burlington
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