Individual provider Active NPI

Beverly Gaye Jones, LPN

  • Public Health or Welfare Agency
  • Rock Hill, SC
National Provider Identifier
1316364722
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
P3004 Issued in SC
Practice address
1070 Heckle Blvd
Rock Hill, SC 29732-2853
Phone
(803) 909-7300
Fax
(803) 909-7397
NPI assigned
Mar 24, 2014
Last updated
Mar 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X P3004 SC Primary

Addresses

Primary practice location

1070 Heckle Blvd
Rock Hill, SC 29732-2853

Mailing address

642 Elm Rd
Chester, SC 29706
Phone (803) 581-1554

Other identifiers 1

IdentifierTypeStateIssuer
P30051MedicaidSC

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P3004SCMDPublic Health or Welfare Agency

NPI Registry JSON

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1316364722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 ELM RD",
            "city": "CHESTER",
            "state": "SC",
            "postal_code": "29706",
            "telephone_number": "803-581-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 HECKLE BLVD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322853",
            "telephone_number": "803-909-7300",
            "fax_number": "803-909-7397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "BEVERLY",
        "middle_name": "GAYE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "SC",
            "license": "P3004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P30051",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.