Active NPI
Jacob A McKenna
- Emergency Medicine Physician
- Columbia, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 89728
- Practice address
- 14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896 - Phone
- (803) 434-3790
- NPI assigned
- Apr 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 89728 | SC | Primary |
Addresses
Primary practice location
14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 695-6697
Other practice location 1
1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4780
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Alabama College of Osteopathic Medicine, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14 Richland Medical Park Dr
Suite 350
Columbia, SC 29203-6896
Phone (803) 434-1319
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89728 | SC | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Self Medical Group | Current | Accepting new patients | |
| Self Medical Group | Current | Accepting new patients | |
| Self Medical Group | Emergency Medicine | Current | Accepting new patients |
| Self Medical Group | Past | Accepting new patients |
Locations
75 Remittance Dr
Dept 6764
Chicago, IL 60675
1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111
2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866
Interoperability endpoints
- jmckenna650445@direct.ghs.myhfn.org
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Columbia, SC
- NPI 1275988321
-
- Surgery Physician
- Greenwood, SC
- NPI 1982836847
-
- Diagnostic Radiology Physician
- Greenwood, SC
- NPI 1659839694
-
- Emergency Medicine Physician
- Greenwood, SC
- NPI 1740788165
-
- Gastroenterology Physician
- Greenwood, SC
- NPI 1841047560
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sumter, SC
- NPI 1326043548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760313600000",
"number": "1063107167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE FL 4",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012842",
"telephone_number": "864-695-6697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 RICHLAND MEDICAL PARK DR STE 350",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292036896",
"telephone_number": "803-434-3790"
}
],
"practiceLocations": [
{
"address_1": "1325 Spring St",
"address_purpose": "LOCATION",
"city": "Greenwood",
"state": "SC",
"postal_code": "296463860",
"country_code": "US",
"telephone_number": "864-725-4780",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKENNA",
"first_name": "JACOB",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-06",
"last_updated": "2025-10-13",
"certification_date": "2025-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "89728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.