Basic Information
| Provider Information | |||||||||
| NPI: | 1720278500 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOFF | ||||||||
| FirstName: | JEREMY | ||||||||
| MiddleName: | JAY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2716 ASHTON DR | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284122489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103323800 | ||||||||
| FaxNumber: | 9102510421 | ||||||||
| Practice Location | |||||||||
| Address1: | 2716 ASHTON DR | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9103323800 | ||||||||
| FaxNumber: | 9102510421 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2007 | ||||||||
| LastUpdateDate: | 06/11/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | 0102202405 | VA | N | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 208100000X | 0102202405 | VA | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208VP0014X | 2018-01336 | NC | N | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 208100000X | 2018-01336 | NC | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 1720278500 | 01 | VA | SENTARA HEALTH PLANS | OTHER | 1720278500 | 01 | VA | COVENTRY/MAILHANDLERS | OTHER | 2329969 | 01 | VA | CIGNA | OTHER | 541869550 | 01 | VA | TRICARE | OTHER | 1720278500 | 01 | VA | BLUE CROSS BLUE SHIELD | OTHER | 1720278500 | 01 | VA | MAMSI/UHC | OTHER | 1720278500 | 01 | VA | AETNA | OTHER | 1720278500 | 05 | VA | MEDICAID |