Kelly Lee Jeanes, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3476 Issued in SC

Practice address

10 Patewood Dr Ste 130
Greenville, SC 29615-6317

Phone

(864) 455-8988

Fax

(864) 522-5555

NPI assigned

Jan 19, 2020

Last updated

May 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjeanes273323@direct.ghs.myhfn.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment Care Compare group
• Prisma Health University Medical Group

  dba Parkside OB-GYN

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Prisma Health University Medical Group

  dba Eastside Pediatrics, PA

  • Pediatrics Physician
  • Taylors, SC
  • NPI 1801524392
  NPD

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

{
    "created_epoch": "1579392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1316577315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PATEWOOD DR STE 130",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156317",
            "telephone_number": "864-455-8988",
            "fax_number": "864-522-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANES",
        "first_name": "KELLY",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-19",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4104PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjeanes273323@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kjeanes273323@direct.ghs.myhfn.org",
            "address_1": "10 Patewood Dr Ste 130",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296156317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jason Kent Counseling LLC
• Megan Jay, CRNA
• Jared Stephen Jaynes, MD
• Lauren Hughes Jaynes, OTR/L
• Roger Stephen Jaynes, DC
• Christopher Michael Jeanfreau
• Hannah Makant Jeanfreau
• Jeff Bernat PHD, P.C.
• Ashley S Jefferies
• Cathleen Castay Jeffers, FNP-C

• Physician Assistant in Greenville, SC
• Providers in Greenville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; 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.

Verify at the official NPI Registry.