Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jerry A. Quisenberry, PA-C

Individual provider Physician Assistant · NPI 1639111768

Mr. Jerry A. Quisenberry, PA-C is a Physician Assistant in Madison, West Virginia. Qualified in 2000, 26 years ago. Practices with Lincoln County Primary Care Center Inc, a 40-clinician group and accepts Medicare assignment. Licensed in West Virginia.

Years since qualifying
26
Licensed in
WV
In the registry since
2006
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

471 Main St
Madison, WV 25130-1223
Phone: (304) 369-5170
Fax: (304) 369-0946
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 867 (WV)

Record details

NPI number1639111768
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 12, 2006
Last updated in NPPESFebruary 12, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Lincoln County Primary Care Center Inc — 40 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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