JACK LLORRAC BAGLEY PA-C
NPI 1083653745
Physician Assistant in Wilmington, NC

Active since June 06, 2006PECOS EnrolledAccepts Medicare Assignment
2208 S 17TH ST, WILMINGTON, NC 28401(910) 763-3333 Get Directions Write a Review

NPPES record last updated: April 6, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 6, 2026, Dec 22, 2025, Jun 2, 2025 and 1 more (4 updates tracked since 2021).

About Jack Llorrac Bagley Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK LLORRAC BAGLEY PA-C (NPI 1083653745) is an individual physician assistant in Wilmington, North Carolina, licensed in North Carolina (103055) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Greensboro, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1083653745
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJACK LLORRAC BAGLEYCredential: PA-C
Location Address2208 S 17TH STWilmington, NC 28401-7593
Mailing AddressPo Box 96860Charlotte, NC 28296-6860 · (704) 542-6111 · Fax (704) 542-1239
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateJune 6, 2006
Last NPPES UpdateApril 6, 20264 updates tracked since enumeration
NPPES CertifiedApril 6, 2026
NPI 1083653745 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses Licensed in NC · 103055 Licensed in MO · 2006004610
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

2208 S 17TH ST, Wilmington, NC 28401

Secondary Practice Location 1

Location 11002 N Church St Ste 200Greensboro, NC 27401-1448 · Phone (336) 907-7773 · Fax (336) 907-7902

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jack Llorrac Bagley Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547266124
PECOS Enrollment IDI20130620000705
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
25 services16 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
18 services18 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Medicine & Rehabilitation
2208 S 17TH ST, SECOND FLOOR
WILMINGTON, NC 28401
Neurological Surgery
2208 S 17TH ST, SUITE 201
WILMINGTON, NC 28401
Nurse Practitioner (Family)
2208 S 17TH ST
WILMINGTON, NC 28401
Specialist
2208 S 17TH ST, SUITE 201
WILMINGTON, NC 28401
Nurse Practitioner (Family)
2208 S 17TH ST
WILMINGTON, NC 28401
Physical Medicine & Rehabilitation (Spinal Cord Injury Medicine)
2208 S 17TH ST, SECOND FLOOR
WILMINGTON, NC 28401
Physician Assistant
2208 S 17TH ST
WILMINGTON, NC 28401
Specialist
2208 S 17TH ST, SUITE 201
WILMINGTON, NC 28401

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Bagley's NPI number?

The NPI number for Jack Bagley is 1083653745. It was assigned to this individual provider in the NPPES registry on June 6, 2006.

Where is Jack Bagley located?

Jack Bagley practices at 2208 S 17th St, Wilmington, NC 28401. The listed phone number is (910) 763-3333.

What is Jack Bagley's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jack Bagley enrolled in Medicare?

Yes. Jack Bagley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jack Bagley accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, Blue Cross and Blue Shield of NC and UnitedHealthcare list Jack Bagley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jack Bagley was last updated on April 6, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.