NPIMap

Individual provider Active NPI

Jessica Rose Halford, PA-C

  • Medical Physician Assistant
  • Myrtle Beach, SC
National Provider Identifier
1093521676
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5774 Issued in SC
Practice address
931 Medical Cir Ste a
Myrtle Beach, SC 29572-4122
Phone
(843) 945-8117
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X 5774 SC Primary

Addresses

Primary practice location

931 Medical Cir Ste a
Myrtle Beach, SC 29572-4122

Mailing address

355 Castle Dr
Myrtle Beach, SC 29579-6000
Phone (508) 221-3624

Other practice location 1

121 Houston St
Lenoir City, TN 37771-8058
Phone (508) 221-3624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250410002010 SC Practitioner - Physician Assistant 1254855372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family First Health Clinic PAGroup PAC ID 9537499785, 4 clinicians

Practice addresses (Care Compare)

4612 Oleander Dr
Suite 102
Myrtle Beach, SC 29577-5711
Phone (843) 945-8117

Hospital & facility affiliations

  • Amedisys Home Health of Conway Home health agency, Conway, SC, CCN 427112
  • Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085
  • Conway Medical Center Hospital, Conway, SC, CCN 420049
  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105
  • Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: jessica.halford.1@20060.direct.athenahealth.com

Organizations & group practices 1

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1093521676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 CASTLE DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796000",
            "telephone_number": "508-221-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 MEDICAL CIR STE A",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724122",
            "telephone_number": "843-945-8117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Houston St",
            "address_purpose": "LOCATION",
            "city": "Lenoir City",
            "state": "TN",
            "postal_code": "377718058",
            "country_code": "US",
            "telephone_number": "508-221-3624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALFORD",
        "first_name": "JESSICA",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "5774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.