Individual provider Active NPI

Jay Graham Jamison, MD

  • Emergency Medicine Physician
  • Charleston, SC
National Provider Identifier
1073359972
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MMD.92684 Issued in SC
Practice address
96 Jonathan Lucas St
Charleston, SC 29425-8900
Phone
(843) 876-8023
NPI assigned
Jul 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MMD.92684 SC Primary

Addresses

Primary practice location

96 Jonathan Lucas St
Charleston, SC 29425-8900

Mailing address

169 Ashley Avenue
Room 202 Main Hospital, Msc333
Charleston, SC 29425
Phone (843) 876-8023

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241001002877 SC Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 8628509601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MMD.92684SCMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1073359972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL, MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-876-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258900",
            "telephone_number": "843-876-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMISON",
        "first_name": "JAY",
        "middle_name": "GRAHAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "MMD.92684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.