Active NPI
Jackqueline Ballentine Sims, FNP
- Psychiatric/Mental Health Nurse Practitioner
- Greenwood, SC
National Provider Identifier
1275866840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 3980
- Practice address
- 1547 Parkway
Greenwood, SC 29646-4081 - Phone
- (864) 229-7120
- NPI assigned
- Sep 14, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F3980 | SC | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 3980 | SC | Primary |
Addresses
Primary practice location
1547 Parkway
Greenwood, SC 29646-4081
Mailing address
1547 Parkway
Greenwood, SC 29646-4081
Phone (864) 229-7120
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 421504 | Medicaid | SC | |
| 3335 | Other | SC | MEDICARE |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241025002774 | SC | Practitioner - Nurse Practitioner | 4981137163 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1547 Pkwy
Suite 200
Greenwood, SC 29646-4081
Phone (864) 223-8331
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F3980 | SC | MD | Family Nurse Practitioner |
| 3980 | SC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina Dept of Mental Health Accounting Office | Current | Accepting new patients | |
| South Carolina Dept of Mental Health Accounting Office | Current | Accepting new patients | |
| South Carolina Dept of Mental Health Accounting Office | Current | Accepting new patients | |
| Premise Health of South Carolina Medical, P.C | Past | Accepting new patients | |
| South Carolina Dept of Mental Health Accounting Office | Past | Accepting new patients |
Locations
125 E Robinson St
Gaffney, SC 29340
Phone (864) 487-2710
1547 Parkway
Ste 200
Greenwood, SC 29646
Phone (864) 223-8331
1547 Parkway
Greenwood, SC 29646
Phone (864) 223-8331
Organizations & group practices 5
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.
-
- Primary Care Nurse Practitioner
- Bennettsville, SC
- NPI 1295332690
SC
-
- Community/Behavioral Health Agency
- Columbia, SC
- NPI 1083421994
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Greenwood, SC
- NPI 1124135009
-
- Occupational Medicine Clinic/Center
- Newberry, SC
- NPI 1336576610
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Spartanburg, SC
- NPI 1427168889
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770681600000",
"number": "1275866840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1547 PARKWAY",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296464081",
"telephone_number": "864-229-7120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1547 PARKWAY",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296464081",
"telephone_number": "864-229-7120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMS",
"first_name": "JACKQUELINE",
"middle_name": "BALLENTINE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-14",
"last_updated": "2026-02-10",
"certification_date": "2026-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "F3980",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "SC",
"license": "3980",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "421504",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "3335",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greenwood, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.