JACKSON PAUL MCCLEES DO
NPI 1366298739
Student in an Organized Health Care Education/Training Program in Greenville, NC

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since April 26, 2024PECOS Enrolled

2100 STANTONSBURG RD, GREENVILLE, NC 27834(252) 744-4611(252) 744-0060 Get Directions Write a Review

NPPES record last updated: June 22, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 22, 2024, Apr 26, 2024 (2 updates tracked since 2024).

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About Jackson Paul Mcclees Do NPPES

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

JACKSON PAUL MCCLEES DO (NPI 1366298739) is an individual student in an organized health care education/training program in Greenville, North Carolina, licensed in North Carolina (RTL24-0617) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1366298739

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACKSON PAUL MCCLEESCredential: DO

Location Address2100 STANTONSBURG RDGreenville, NC 27834-2818

Mailing Address2100 Stantonsburg RdGreenville, NC 27834-2818 · (252) 744-4611 · Fax (252) 744-0060

Phone(252) 744-4611

Fax(252) 744-0060

Sole ProprietorNo

Enumeration DateApril 26, 2024

Last NPPES UpdateJune 22, 20242 updates tracked since enumeration

NPPES CertifiedJune 22, 2024

✔ NPI 1366298739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in NC · RTL24-0617

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2100 STANTONSBURG RD, Greenville, NC 27834

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackson Paul Mcclees Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.