Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacob Connor Lansberry, PA-C

Individual provider Physician Assistant · NPI 1912681867

Jacob Connor Lansberry, PA-C is a Physician Assistant in Raleigh, North Carolina. Qualified in 2023, 3 years ago. Practices with Wakemed Specialists Group LLC, a 869-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
3
Licensed in
NC
In the registry since
2023
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3009 New Bern Ave
Raleigh, NC 27610-1214
Phone: (919) 232-5020
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 0010-13502 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 0010-13502 (NC)
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1912681867
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 12, 2023
Last updated in NPPESSeptember 26, 2023
Certification dateSeptember 26, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Wakemed Specialists Group Llc — 869 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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