Active NPI
Paul F Jacques, PA
- Medical Physician Assistant
- N Charleston, SC
National Provider Identifier
1295749943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- A857
- Practice address
- 2233 Northwoods Blvd
N Charleston, SC 29405 - Phone
- (866) 448-1641
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | A857 | Primary |
Addresses
Primary practice location
2233 Northwoods Blvd
N Charleston, SC 29405
Mailing address
PO Box 751137
Charlotte, NC 28275-1137
Phone (866) 448-1641
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 857 | SC | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203897600000",
"number": "1295749943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751137",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751137",
"telephone_number": "866-448-1641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2233 NORTHWOODS BLVD",
"city": "N CHARLESTON",
"state": "SC",
"postal_code": "29405",
"telephone_number": "866-448-1641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACQUES",
"first_name": "PAUL",
"middle_name": "F",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2008-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": "A857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in N Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.