Haley Meharg Jackson, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

21336 Issued in SC

Practice address

1920 2ND Loop Rd
Florence, SC 29501-6123

Phone

(843) 432-3700

NPI assigned

Sep 27, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Haley Amanda Meharg Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Hopehealth Inc

  • Federally Qualified Health Center (FQHC)
  • Florence, SC
  • NPI 1821002411
  Medicare reassignment NPD
• Hopehealth Inc

  • Federally Qualified Health Center (FQHC)
  • Florence, SC
  • NPI 1194322586
  NPD
• Hopehealth Inc

  • Federally Qualified Health Center (FQHC)
  • Lake City, SC
  • NPI 1649069618
  NPD

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1255840773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 2ND LOOP RD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295016123",
            "telephone_number": "843-432-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "HALEY",
        "middle_name": "MEHARG",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "21336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "MEHARG",
            "middle_name": "AMANDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Marie Jackel, PH.D.
• Arthenius Jackson, MS
• Charlene Jackson
• Cheryl Jackson
• Cradeja Shovon Jackson
• Kristin Gayle Jackson
• Latisha Simone Jackson, LPC
• Sholonda Jackson, RN
• William Jackson, D.O.
• Denise Jacobs, FNP

• Pediatric Nurse Practitioner in Florence, SC
• Providers in Florence, SC by specialty
• Pediatric Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.