Active NPI
Julianna Marie Detrane, PA-C
- Physician Assistant
- Goose Creek, SC
National Provider Identifier
1356944680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3753
- Practice address
- 7 S Alliance Dr Ste 211B
Goose Creek, SC 29445-7297 - Phone
- (843) 553-4383
- Fax
- (843) 553-4384
- NPI assigned
- Nov 19, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3753 | SC | Primary |
Addresses
Primary practice location
7 S Alliance Dr Ste 211B
Goose Creek, SC 29445-7297
Mailing address
201 Sigma Dr Ste 100
Summerville, SC 29486-7722
Phone (843) 553-4383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3753 | SC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1356944680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 SIGMA DR STE 100",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294867722",
"telephone_number": "843-553-4383",
"fax_number": "843-553-4384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 S ALLIANCE DR STE 211B",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "294457297",
"telephone_number": "843-553-4383",
"fax_number": "843-553-4384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETRANE",
"first_name": "JULIANNA",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-19",
"last_updated": "2020-11-19",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SC",
"license": "3753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goose Creek, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.