Individual provider Active NPI

Jesse William Price III, PA-C

  • Medical Physician Assistant
  • Mount Pleasant, SC
National Provider Identifier
1093091761
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1738 Issued in SC
Practice address
180 Wingo Way
Suite 306
Mt Pleasant, SC 29464-1812
Phone
(843) 884-1777
Fax
(843) 884-0710
NPI assigned
Oct 26, 2011
Last updated
Jan 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1738 SC Primary

Addresses

Primary practice location

180 Wingo Way
Suite 306
Mt Pleasant, SC 29464-1812

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1579PAMedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jesse.Price@rsfpp.eclinicaldirectplus.com Direct

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
I20130225000435 SC Practitioner - Physician Assistant 8426203381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

180 Wingo Way
Mount Pleasant, SC 29464-1812

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

319 Folly Rd
Charleston, SC 29412-2518
Phone (843) 723-8823

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1738SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince Jan 14, 2013 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jan 14, 2013 Accepting new patients
Roper Saint Francis Physicians Network Past Accepting new patients

Locations

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

180 Wingo Way
Ste 306
Mt Pleasant, SC 29464
Phone (843) 884-1777

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

Interoperability endpoints

  • Direct secure messaging: jesse.price@rsfpp.eclinicaldirectplus.com
  • Direct secure messaging: jprice1236583@direct.bsmhealth.org

Organizations & group practices 4

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

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": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1093091761",
    "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": "180 WINGO WAY",
            "address_2": "SUITE 306",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294641812",
            "telephone_number": "843-884-1777",
            "fax_number": "843-884-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "JESSE",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-26",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1579PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jesse.Price@rsfpp.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Document and CCD Exchange",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient Care Documents",
            "address_1": "180 Wingo Way",
            "address_2": "Suite 306",
            "city": "Mt Pleasant",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294641812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.