Individual provider Active NPI

Jessica Lynn Brown, PA-C

  • Medical Physician Assistant
  • Charleston, SC
National Provider Identifier
1306381702
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2647 Issued in SC
Practice address
2097 Henry Tecklenburg Dr Ste 305W
Charleston, SC 29414
Phone
(843) 763-3360
Fax
(843) 763-3038
NPI assigned
Dec 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MPA2647PA SC
Medical Physician Assistant 363AM0700X 2647 SC Primary

Addresses

Primary practice location

2097 Henry Tecklenburg Dr Ste 305W
Charleston, SC 29414

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other practice location 1

418 Folly Rd
Suite A
Charleston, SC 29412-2625
Phone (843) 795-5362

Other identifiers 1

IdentifierTypeStateIssuer
2849PAMedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jessica.Brown@rsfpp.eclinicaldirectplus.com Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170405000248 SC Practitioner - Physician Assistant 3072899145 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1600 Midtown Ave
Mount Pleasant, SC 29464-3771
Phone (843) 792-1414

167 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

2060 Sam Rittenberg Blvd
Charleston, SC 29407-4616
Phone (843) 792-1414

Hospital & facility affiliations

  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Physician Assistant

State licenses

LicenseStateTypeSpecialty
2647SCMDPhysical Therapy Assistant
MPA2647PASCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince Dec 1, 2023 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Nov 25, 2018 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Nov 25, 2018 Accepting new patients

Locations

2097 Henry Tecklenburg Dr
Ste 305W
Charleston, SC 29414
Phone (843) 724-1950

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Interoperability endpoints

  • Direct secure messaging: jessica.brown@rsfpp.eclinicaldirectplus.com
  • Direct secure messaging: jessica.brown.p1@direct.llcc.nextgenshare.com
  • Direct secure messaging: jbrown451407@direct.musc.edu

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1306381702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2097 HENRY TECKLENBURG DR STE 305W",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29414",
            "telephone_number": "843-763-3360",
            "fax_number": "843-763-3038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "418 Folly Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294122625",
            "country_code": "US",
            "telephone_number": "843-795-5362",
            "fax_number": "843-795-1921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "MPA2647PA",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "2647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2849PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jessica.Brown@rsfpp.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Document and CCD Exchange",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient Care Documents",
            "address_1": "2097 Henry Tecklenburg Dr Ste 305W",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.