Jackie Smalls, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2018-02169 Issued in NC

Practice address

521 Moye Blvd
Greenville, NC 27834

Phone

(252) 744-3229

Fax

(252) 744-3924

NPI assigned

May 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Pelham Medical CenterGroup PAC ID 2365519097, 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007
• Cherokee Medical Center Hospital, Gaffney, SC, CCN 420043
• Pelham Medical Center Hospital, Greer, SC, CCN 420103

Merit-based Incentive Payment System (MIPS)

Final score

94.7 of 100Reported as apm

Quality

89.4

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsmalls219635@direct-srhs.et0939.epichosted.com

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.

• Pelham Medical Center

  • Emergency Medicine Physician
  • Greer, SC
  • NPI 1619133568
  Medicare reassignment Care Compare group NPD
• Spartanburg Medical Center

  • Emergency Medicine Physician
  • Spartanburg, SC
  • NPI 1699729939
  Medicare reassignment Care Compare group NPD
• Pelham Medical Center

  • Internal Medicine Physician
  • Greer, SC
  • NPI 1245496983
  NPD
• Pelham Medical Center

  • Pain Medicine Physician
  • Greer, SC
  • NPI 1942960844
  NPD
• Spartanburg Medical Center

  • Family Medicine Physician
  • Drayton, SC
  • NPI 1750573036
  NPD
• Spartanburg Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1942188875
  NPD
• Spartanburg Medical Center

  • General Acute Care Hospital
  • Spartanburg, SC
  • NPI 1609807122
  NPD (past)

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

• Cherokee Medical Center

  • General Acute Care Hospital
  • Gaffney, SC
  • NPI 1205307378
  Care Compare affiliation
• Pelham Medical Center

  • Pain Medicine Physician
  • Greer, SC
  • NPI 1942960844

  Hospital

  Care Compare affiliation
• Pelham Medical Center

  • General Acute Care Hospital
  • Greer, SC
  • NPI 1982800397
  Care Compare affiliation
• Spartanburg Medical Center

  • Psychiatric Hospital Unit
  • Spartanburg, SC
  • NPI 1033681630
  Care Compare affiliation
• Spartanburg Medical Center

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1326373697

  Hospital

  Care Compare affiliation
• Spartanburg Medical Center

  • General Acute Care Hospital
  • Spartanburg, SC
  • NPI 1609807122
  Care Compare affiliation
• Spartanburg Medical Center

  • Rehabilitation Hospital Unit
  • Spartanburg, SC
  • NPI 1942772546
  Care Compare affiliation

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1164801098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MOYE BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27834",
            "telephone_number": "252-744-3229",
            "fax_number": "252-744-3924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Wood St Ste 401",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033040",
            "country_code": "US",
            "telephone_number": "864-560-6654",
            "fax_number": "864-560-7353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMALLS",
        "first_name": "JACKIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-26",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2018-02169",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "85218",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164801098",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NN42610322",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCJ2035019",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "852189",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCJ2039068",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "19YU8",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmalls219635@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jsmalls219635@direct-srhs.et0939.epichosted.com",
            "address_1": "101 E Wood St Ste 401",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293033040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Brandon Ross Slockbower, M.D.
• Annie Laurie Slye, M.S., OTR/L
• Ahlea Lynn Small
• Kia Small
• Beverly S Smallwood, FNP-C
• Richelle Lafaye Smallwood, LCSW
• Kathryn Ann Smeltzer
• Jessie L Smiley, CRNA
• Michelle Smith-Breaux, MPH, RD, LD, CHES

• Internal Medicine Physician in Greenville, NC
• Providers in Greenville, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.