MRS. JESSICA J. DOUTAZ MS, AGNP
NPI 1194106674
Nurse Practitioner - Adult Health in Statesville, NC

Q: What is Jessica Doutaz's NPI number?

The NPI number for Jessica Doutaz is 1194106674. It was assigned to this individual provider in the NPPES registry on June 10, 2015.

Q: What is Jessica Doutaz's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Doutaz was last updated on February 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 10, 2015PECOS EnrolledAccepts Medicare Assignment

208 OLD MOCKSVILLE RD, STATESVILLE, NC 28625(704) 838-8240(704) 924-5360 Get Directions Write a Review

NPPES record last updated: February 19, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 15, 2023, Dec 27, 2021, Dec 29, 2020 and 2 more (5 updates tracked since 2016).

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About Mrs. Jessica J. Doutaz Ms, Agnp NPPES

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

MRS. JESSICA J. DOUTAZ MS, AGNP (NPI 1194106674) is an individual adult health provider in Statesville, North Carolina, licensed in North Carolina (5021443) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, is affiliated with Iredell Memorial Hospital Inc, and maintains a secondary practice location in Greer.

NPPES Registry Identity

NPI1194106674

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMRS. JESSICA J. DOUTAZCredential: MS, AGNP

Location Address208 OLD MOCKSVILLE RDStatesville, NC 28625-1953

Mailing AddressPo Box 1845Statesville, NC 28687-1845 · (704) 873-4277 · Fax (704) 978-3549

Phone(704) 838-8240

Fax(704) 924-5360

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateJune 10, 2015

Last NPPES UpdateFebruary 19, 20265 updates tracked since enumeration

NPPES CertifiedFebruary 19, 2026

✔ NPI 1194106674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

Licenses✔ Licensed in NC · 5021443✔ Licensed in SC · 24954

208 OLD MOCKSVILLE RD, Statesville, NC 28625

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Secondary Practice Location 1

Location 1805 W Wade Hampton Blvd Ste CGreer, SC 29650-1311 · Phone (864) 655-6615 · Fax (855) 617-4423

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Cigna Healthcare, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Jessica J. Doutaz Ms, Agnp 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 ID2668788233

PECOS Enrollment IDI20250415003818

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.

Medicare Billing Reassignments

Medicare enrollment records show Jessica Doutaz reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Piedmont Healthcare, P.A.

1.4 mi

Internal Medicine

650 SIGNAL HILL DRIVE EXT
Statesville, NC 28625

Reassigned Medicare billing, North Carolina enrollment
Medicare enrollment name: Piedmont Healthcare PA
186 clinicians in this Medicare group

NPI 1912999897 (704) 873-4277

Optimed Hospitalists

3.0 mi

Hospitalist

557 BROOKDALE DRIVE
Statesville, NC 28677

Reassigned Medicare billing, North Carolina enrollment
54 clinicians in this Medicare group

NPI 1235449125 (704) 873-5661

Centerwell Senior Primary Care (sc) PC

84 mi

Internal Medicine

1855 E MAIN ST STE 21A
Spartanburg, SC 29307

Reassigned Medicare billing, South Carolina enrollment
86 clinicians in this Medicare group

NPI 1154974343 (864) 913-4370

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

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 moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

40 services26 patients

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.

17 services16 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Iredell Memorial Hospital Inc

Acute Care Hospitals · Statesville, NC

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340039

Location557 Brookdale DrStatesville, NC 28677 · Iredell County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28625 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

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

Most-billed visit code 99214

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 20

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

DANIEL RHYNE WHITE

Surgery