JERRY LEE STORK P.A.
NPI 1467479550
Physician Assistant in Hattiesburg, MS

Q: What is Jerry Stork's NPI number?

The NPI number for Jerry Stork is 1467479550. It was assigned to this individual provider in the NPPES registry on July 16, 2006.

Q: What is Jerry Stork's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jerry Stork was last updated on October 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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 July 16, 2006PECOS Enrolled

3688 VETERANS MEMORIAL DR, 200, HATTIESBURG, MS 39401(601) 554-7402(601) 554-7488 Get Directions Write a Review

NPPES record last updated: October 19, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jerry Lee Stork P.a. NPPES

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

JERRY LEE STORK P.A. (NPI 1467479550) is an individual physician assistant in Hattiesburg, Mississippi, licensed in Mississippi (PA00079) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467479550

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJERRY LEE STORKCredential: P.A.

Location Address3688 VETERANS MEMORIAL DR, 200Hattiesburg, MS 39401-8246

Mailing Address3688 Veterans Memorial Dr, 200Hattiesburg, MS 39401-8246 · (601) 554-7402 · Fax (601) 554-7488

Phone(601) 554-7402

Fax(601) 554-7488

Sole ProprietorNo

Enumeration DateJuly 16, 2006

Last NPPES UpdateOctober 19, 2021

NPPES CertifiedOctober 19, 2021

✔ NPI 1467479550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MS · PA00079

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.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA9103513 (FL)

3688 VETERANS MEMORIAL DR, Hattiesburg, MS 39401

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jerry Lee Stork P.a. 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.

Areas of Expertise CMS Part B claims

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39401 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

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$64.96 typical visit price

range $16.15 – $129.61

Typical copayment $16.24 (range $4.03 – $32.40)

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.

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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.

DR. D ENISE W REYNOLDS M.D.

Anesthesiology

3688 VETERANS MEMORIAL DR, SUITE 200
HATTIESBURG, MS 39401

Forrest County (601) 554-7402

RILEY PHILLIPS PA-C

Physician Assistant

3688 VETERANS MEMORIAL DR
HATTIESBURG, MS 39401

Forrest County (601) 554-7400

DR. MICHAEL C PATTERSON M.D.,

Orthopaedic Surgery (Orthopaedic Surgery of the Spine)

3688 VETERANS MEMORIAL DR, SUITE 200
HATTIESBURG, MS 39401

Forrest County (601) 554-7400

CLIFTON H DAVIS P.A.-C

Physician Assistant (Medical)

3688 VETERANS MEMORIAL DR, SUITE 200
HATTIESBURG, MS 39401

Forrest County (601) 554-7400

KIMBERLY T SIMNICHT CFNP

Specialist

3688 VETERANS MEMORIAL DR, STE 200
HATTIESBURG, MS 39401

Forrest County (601) 554-7400

MR. JIMMIE G MOORE JR. PA-C

Physician Assistant (Medical)

3688 VETERANS MEMORIAL DR, SUITE 200
HATTIESBURG, MS 39401

Forrest County (601) 554-7400

MARSHALL BYNUM PA

Physician Assistant (Medical)

3688 VETERANS MEMORIAL DR, SUITE 200
HATTIESBURG, MS 39401

Forrest County (601) 554-7400

DR. JAMES A ANTINNES M.D.,

Orthopaedic Surgery (Orthopaedic Surgery of the Spine)

3688 VETERANS MEMORIAL DR, SUITE 200
HATTIESBURG, MS 39401

Forrest County (601) 554-7451

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 Jerry Stork's NPI number?

The NPI number for Jerry Stork is 1467479550. It was assigned to this individual provider in the NPPES registry on July 16, 2006.

Where is Jerry Stork located?

Jerry Stork practices at 3688 Veterans Memorial Dr 200, Hattiesburg, MS 39401. The listed phone number is (601) 554-7402.

What is Jerry Stork's specialty?

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

Is Jerry Stork enrolled in Medicare?

Yes. Jerry Stork is registered in the Medicare PECOS enrollment system.

What insurance does Jerry Stork accept?

Health plans from Blue Cross and Blue Shield of Alabama list Jerry Stork 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 Jerry Stork was last updated on October 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.