Doctor profile · Federal record

Dr. JACK BAGLEY, PA-C

Physician Assistant · Physician Assistant · WILMINGTON, NC

  • NPI 1083653745
  • Accepts Medicare
  • 26 yrs in practice
  • Licensed in 2 states
  • Male
  • Group practice
  • No sanctions

Practice & contact

Operates at 2 locations .

NPPES Updated May 11, 2026
Primary practice
2208 S 17TH ST
WILMINGTON, NC 284017593
(910) 763-3333
Additional location
1002 N Church St Ste 200
Greensboro, NC 274011448
(336) 907-7773
fax (336) 907-7902
Mailing address
PO BOX 96860
CHARLOTTE, NC 282966860

Credentials & registration

NPPES · NUCC
NPI registered
June 2006 — 20 yrs on file
Profile last updated
April 6, 2026
Year of graduation
2000 — 26 yrs since
Specialty taxonomy
363A00000X — NUCC code
State licenses (2)
North Carolina #103055 · Missouri #2006004610

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1083653745. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
63
Distinct HCPCS
3
Medicare allowed
$6,056
HCPCS Description Services Patients Avg allowed
99213 Established patient office or other outpatient visit, 20-29 minutes 28 16 $73
99214 Established patient office or other outpatient visit, 30-39 minutes 18 13 $103
99204 New patient office or other outpatient visit, 45-59 minutes 17 17 $128

In context: peer comparison

Among 91 peers in this city , average services per provider: 128. This provider delivers 0.5× the peer median.