Individual provider Active NPI

Jessica Bannister Robinson, PA

  • Physician Assistant
  • Manning, SC
National Provider Identifier
1124493200
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2446 Issued in SC
Practice address
12 W South St
Manning, SC 29102-2925
Phone
(803) 433-4124
Fax
(803) 433-4230
NPI assigned
Dec 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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 2446 SC Primary

Addresses

Primary practice location

12 W South St
Manning, SC 29102-2925

Mailing address

360 N Irby St
Florence, SC 29501-2808
Phone (843) 667-9414

Other identifiers 1

IdentifierTypeStateIssuer
2446PAMedicaidSC

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
I20170222002417 SC Practitioner - Physician Assistant 3779877501 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hopehealth, Inc CurrentSince Oct 8, 2017 Accepting new patients
Hopehealth Inc CurrentSince Oct 8, 2017 Accepting new patients

Locations

360 N Irby St
Florence, SC 29501
Phone (843) 656-0353

600 E Palmetto St
Florence, SC 29506
Phone (843) 656-0390

12 W South St
Manning, SC 29102
Phone (803) 433-4124

11 W Hospital St
Manning, SC 29102
Phone (803) 433-4124

2155 Paxville Hwy
Manning, SC 29102
Phone (803) 433-4321

Interoperability endpoints

  • Direct secure messaging: jessica.robinson.1@14320.direct.athenahealth.com
  • Direct secure messaging: jessica.robinson@hop.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1124493200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W SOUTH ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291022925",
            "telephone_number": "803-433-4124",
            "fax_number": "803-433-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JESSICA",
        "middle_name": "BANNISTER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2446PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manning, SC

Sources for this page

Verify at the official NPI Registry.