Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jerald Dean Grissom Jr., PA-C

Individual provider Physician Assistant · NPI 1912960659

Jerald Dean Grissom Jr., PA-C is a Physician Assistant in Winston Salem, North Carolina. Licensed in North Carolina. Registered with an NPI since 2006.

Licensed in
NC
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Partly verified

Some contact details are missing from the federal record.

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone: (336) 716-8898
Fax: (336) 716-7277
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-04281 (NC)

Record details

NPI number1912960659
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 11, 2006
Last updated in NPPESFebruary 17, 2014

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