NPIMap

Individual provider Active NPI

Jill Bell Shirley

  • Family Nurse Practitioner
  • Greenwood, SC
National Provider Identifier
1124682315
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22809 Issued in SC
Practice address
105 Vinecrest CT Ste 1000
Greenwood, SC 29646-8031
Phone
(864) 725-3350
NPI assigned
Apr 24, 2019
Last updated
Apr 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22809 SC Primary

Addresses

Primary practice location

105 Vinecrest CT Ste 1000
Greenwood, SC 29646-8031

Mailing address

5617A Highway 185
Hodges, SC 29653-9508
Phone (864) 941-0757

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
I20190524001557 SC Practitioner - Nurse Practitioner 7416290903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians
Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians

Practice addresses (Care Compare)

105 Vinecrest CT
Greenwood, SC 29646-8031

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group CurrentSince Apr 28, 2019 Accepting new patients
Self Regional Healthcare CurrentSince Jan 1, 2026 Accepting new patients
Self Regional Healthcare CurrentSince Jan 1, 2026 Accepting new patients
Self Medical Group CurrentSince Apr 28, 2019 Accepting new patients
Self Medical Group Current Accepting new patients

Locations

75 Remittance Dr
Dept 6793
Chicago, IL 60675

75 Remittance Dr
Dept 6764
Chicago, IL 60675

105 Vinecrest Ct
#1000
Greenwood, SC 29646
Phone (864) 227-5240

105 Vinecrest Ct
Ste 1000
Greenwood, SC 29646
Phone (864) 227-5240

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

22580 Highway 76 E
Ste 200
Laurens, SC 29360
Phone (864) 725-1480

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Organizations & group practices 6

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 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": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1124682315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5617A HIGHWAY 185",
            "city": "HODGES",
            "state": "SC",
            "postal_code": "296539508",
            "telephone_number": "864-941-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VINECREST CT STE 1000",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296468031",
            "telephone_number": "864-725-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "JILL",
        "middle_name": "BELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "22809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.