Individual provider Active NPI

Jennifer C Whitmire, PA

  • Medical Physician Assistant
  • Greenville, SC
National Provider Identifier
1104116664
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1639 Issued in SC
Practice address
St Francis Cardiovascular
317 St. Francis Dr. Ste 120
Greenville, SC 29601-3900
Phone
(864) 255-1317
Fax
(877) 591-6931
NPI assigned
Apr 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X TL1639 SC
Medical Physician Assistant 363AM0700X 1639 SC Primary

Addresses

Primary practice location

St Francis Cardiovascular
317 St. Francis Dr. Ste 120
Greenville, SC 29601-3900

Mailing address

PO Box 743294
Atlanta, GA 30374-3294
Phone (864) 235-7665

Other identifiers 1

IdentifierTypeStateIssuer
3687PAMedicaidSC

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
I20130725000989 SC Practitioner - Physician Assistant 1254379001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Francis Dr
Greenville, SC 29601-3955
Phone (513) 853-8520

317 Saint Francis Dr
Suite 120
Greenville, SC 29601-3900
Phone (864) 516-1170

317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1639SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients

Locations

317 Saint Francis Dr
Ste 340
Greenville, SC 29601
Phone (864) 255-1834

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

317 Saint Francis Dr
Ste 120
Greenville, SC 29601
Phone (864) 225-1317

Interoperability endpoints

  • Direct secure messaging: jwhitmire1156865@direct.bsmhealth.org

Organizations & group practices 2

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 7

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": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1104116664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743294",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743294",
            "telephone_number": "864-235-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST FRANCIS CARDIOVASCULAR",
            "address_2": "317 ST. FRANCIS DR. STE 120",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296013900",
            "telephone_number": "864-255-1317",
            "fax_number": "877-591-6931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMIRE",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "TL1639",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3687PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.