Individual provider Active NPI

Jordan Ashley Grice, APRN

  • Family Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1003667221
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28474 Issued in SC
Practice address
200 College St
Spartanburg, SC 29303-3556
Phone
(864) 582-2411
Fax
(864) 594-0040
NPI assigned
Mar 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 28474 SC
Family Nurse Practitioner 363LF0000X 28474 SC Primary

Addresses

Primary practice location

200 College St
Spartanburg, SC 29303-3556

Mailing address

PO Box 5158
Spartanburg, SC 29304-5158
Phone (864) 582-2411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241213002419 SC Practitioner - Nurse Practitioner 3375079353 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regenesis Organization Community Health CenterGroup PAC ID 8022928001, shared by 9 NPIs, 35 clinicians

Practice addresses (Care Compare)

220 College St
Spartanburg, SC 29303-3556
Phone (864) 582-2411

750 S Church St
Spartanburg, SC 29306-5348
Phone (864) 582-2411

Hospital & facility affiliations

  • Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regenesis Organization Community Health Center CurrentSince Sep 26, 2024 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Sep 26, 2024 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Sep 26, 2024 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Sep 26, 2024 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Sep 26, 2024 Accepting new patients
Regenesis Organization Community Health Center Family Medicine CurrentSince Sep 26, 2024 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Mar 31, 2024 Accepting new patients

Locations

945 E Main St
Spartanburg, SC 29302
Phone (864) 383-9002

301 Crescent Ave
Spartanburg, SC 29306
Phone (864) 582-2817

750 S Church St
Spartanburg, SC 29306
Phone (864) 582-2829

460 Langdon St
Spartanburg, SC 29302
Phone (864) 582-2817

200 College St
Spartanburg, SC 29303

115 Thomas St
#B
Union, SC 29379

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1003667221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5158",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293045158",
            "telephone_number": "864-582-2411",
            "fax_number": "864-594-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 COLLEGE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033556",
            "telephone_number": "864-582-2411",
            "fax_number": "864-594-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRICE",
        "first_name": "JORDAN",
        "middle_name": "ASHLEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "28474",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "28474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.