Individual provider Active NPI

Jessica Sue Taber, WHCNP-BC

  • Women's Health Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1174355986
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
31406 Issued in SC
Practice address
2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone
(843) 402-2028
Fax
(843) 402-2023
NPI assigned
Aug 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 36849 TN
Women's Health Nurse Practitioner 363LW0102X 31406 SC Primary

Addresses

Primary practice location

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (888) 472-0043

Other names 1

  • Jessica Sue Elliott Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241231000328 TN Practitioner - Nurse Practitioner 7012444128 Reassigns benefits to 1 organization
I20260416000796 SC Practitioner - Nurse Practitioner 7012444128 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8536 Palmetto Commerce Pkwy
Suite 501
Ladson, SC 29456-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31406SCMDWomen's Health Nurse Practitioner
36849TNMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Emergency Obstetrics LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

1924 Alcoa Hwy
Knoxville, TN 37920
Phone (865) 305-9000

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

Organizations & group practices 4

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": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1174355986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "888-472-0043",
            "fax_number": "843-724-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145733",
            "telephone_number": "843-402-2028",
            "fax_number": "843-402-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABER",
        "first_name": "JESSICA",
        "middle_name": "SUE",
        "name_prefix": "Miss",
        "credential": "WHCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TN",
            "license": "36849",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "SC",
            "license": "31406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ELLIOTT",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.