Jamila K Pearson

Individual provider Active NPI Contractor · Spartanburg, SC

NPI 1174401368 · NPPES record last updated Aug 25, 2025

Key facts

NPI
1174401368
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
License
65288 (SC)
Practice address
900 Keats Dr Apt 936
Spartanburg, SC 29301-5094
Phone
(864) 621-5456
NPI assigned
Aug 25, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
65288SCMDContractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 65288 SC Yes

Addresses

Primary practice location

900 Keats Dr Apt 936
Spartanburg, SC 29301-5094

Mailing address

900 Keats Dr Apt 936
Spartanburg, SC 29301-5094
Phone (864) 621-5456

Other providers in Spartanburg, SC

All providers in Spartanburg, SC · Contractor in South Carolina

Sources for this page

Verify at the official NPI Registry.