Individual provider Active NPI

Whitney A. Jeffrey, PA-C

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1073804183
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2293 Issued in SC
Practice address
316 Calhoun St
Charleston, SC 29401-1113
Phone
(843) 724-2450
Fax
(843) 724-2455
NPI assigned
Apr 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2293 SC Primary

Addresses

Primary practice location

316 Calhoun St
Charleston, SC 29401-1113

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other practice location 1

210 E DeRenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

Other identifiers 1

IdentifierTypeStateIssuer
2148PAMedicaidSC

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
I20150601001494 SC Practitioner - Physician Assistant 9032379524 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roper Saint Francis Physicians NetworkGroup PAC ID 5193874824, 530 clinicians
24 On Physicians of SC LLCGroup PAC ID 5890127344, 136 clinicians

Practice addresses (Care Compare)

2075 Eagle Landing Blvd
N Charleston, SC 29406-4074
Phone (843) 789-1800

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1006

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 723-6426

Hospital & facility affiliations

  • Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065
  • Roper Hospital Hospital, Charleston, SC, CCN 420087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2293SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince Mar 1, 2021 Accepting new patients
Roper St. Francis Specialty Physicians Physician Assistant CurrentSince Feb 1, 2026 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Mar 1, 2021 Accepting new patients

Locations

2097 Henry Tecklenburg Dr
Ste 211W
Charleston, SC 29414
Phone (843) 958-2555

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

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.

Hospital & facility affiliations 2

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": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1073804183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 CALHOUN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011113",
            "telephone_number": "843-724-2450",
            "fax_number": "843-724-2455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 E DeRenne Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056736",
            "country_code": "US",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFREY",
        "first_name": "WHITNEY",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-22",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2148PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.