=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205685187
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PATRICK JEROME LLOYD PA-C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2024
-----------------------------------------------------
Last Update Date | 05/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 HEART DR
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27834-8982
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-744-4400
-----------------------------------------------------
Fax | 252-744-3987
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 206B CRAVEN ST
-----------------------------------------------------
City | NEW BERN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28560-2152
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number | 0010-15126
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 0010-15126
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------