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

Jesse Illich, PAS1

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1821749383

Jesse Illich, PAS1 is a Physician Assistant in Boone, North Carolina. Qualified in 2023, 3 years ago. Practices with High Country Community Health, a 35-clinician group, works from 6 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
3
Licensed in
NC
In the registry since
2022
Specialties on file
2

Practice location Address checks out

240 Highway 105 Ext Ste 100
Boone, NC 28607-4291
Phone: (828) 264-7311
Fax: (828) 264-7907
Show map & directions

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

Additional practice locations (5)

  • 3200 S University Dr, Davie, FL 33328-2018 — (954) 262-1250
  • 935 State Farm Rd, Boone, NC 28607-4948 — (828) 262-3886
  • 1925 N Bridge St Ste 101, Elkin, NC 28621-2105 — (336) 835-7337
  • 301 E Meeting St Ste 101, Morganton, NC 28655-3594 — (828) 608-0800
  • 448 Cranberry St, Newland, NC 28657-8800 — (828) 737-0221

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-13685 (NC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1821749383
Entity typeIndividual (Type 1)
GenderMale
Credentials PAS1
Sole proprietorNo
NPI enumeratedJanuary 15, 2022
Last updated in NPPESDecember 14, 2023
Certification dateDecember 14, 2023
Mailing addressPo Box 1490, Boone, NC 28607-1490

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 High Country Community Health — 35 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Boone