Individual provider Active NPI

Jessica Carter, MD

  • Anesthesiology Physician
  • Charleston, SC
National Provider Identifier
1295096352
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2017-00277 Issued in NC
Practice address
169 Ashley Ave
Main Hosptial, MSC 333
Charleston, SC 29425-8905
Phone
(843) 792-4638
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X LL34608 SC
Anesthesiology Physician 207L00000X 2017-00277 NC Primary

Addresses

Primary practice location

169 Ashley Ave
Main Hosptial, MSC 333
Charleston, SC 29425-8905

Mailing address

169 Ashley Ave
Main Hosptial, MSC 333
Charleston, SC 29425-8905
Phone (843) 792-4638

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170913004026 NC Practitioner - Anesthesiology 8022381011 Reassigns benefits to 2 organizations
I20210312002268 SC Practitioner - Anesthesiology 8022381011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Duke University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

2825 Randolph Rd
Charlotte, NC 28211-1018
Phone (704) 377-1647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL34608SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Anesthesia Services Group Inc Anesthesiology CurrentSince Oct 1, 2020 Accepting new patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Jul 1, 2024 Accepting new patients
CHS Anesthesia Services Group Inc Anesthesiology PastSince Oct 25, 2020 Accepting new patients

Locations

2825 Randolph Rd
Charlotte, NC 28211
Phone (704) 377-1647

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

118 Professional Park Dr
Rock Hill, SC 29732
Phone (803) 329-3124

Organizations & group practices 3

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1295096352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "address_2": "MAIN HOSPTIAL, MSC 333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "address_2": "MAIN HOSPTIAL, MSC 333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "JESSICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL34608",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2017-00277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.