Individual provider Active NPI

Jessie Mayne, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1134513369
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
19355 Issued in SC
Practice address
220 N Main St
Ste. 500
Greenville, SC 29601-2161
Phone
(919) 443-2360
NPI assigned
Mar 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 19355 SC Primary

Addresses

Primary practice location

220 N Main St
Ste. 500
Greenville, SC 29601-2161

Mailing address

606 Wade Ave
Ste. 100
Raleigh, NC 27605-1390
Phone (919) 443-2360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20191008001027 FL Practitioner - Nurse Practitioner 1153632070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Psychiatric Group PAGroup PAC ID 0446556716, 16 clinicians

Practice addresses (Care Compare)

736 N Magnolia Ave
Orlando, FL 32803-3809
Phone (407) 423-7149

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19355SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Psychiatric Group, PA CurrentSince Aug 15, 2019 Accepting new patients

Locations

736 N Magnolia Ave
Orlando, FL 32803
Phone (407) 423-7149

Interoperability endpoints

  • Direct secure messaging: apghealthcare.jessiemayne@139541.advancedmd-direct.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.

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1134513369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 WADE AVE",
            "address_2": "STE. 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051390",
            "telephone_number": "919-443-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N MAIN ST",
            "address_2": "STE. 500",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012161",
            "telephone_number": "919-443-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNE",
        "first_name": "JESSIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "19355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.