Individual provider Active NPI

Jeri Lynn Andrews, APRN, FNP-BC

  • Family Nurse Practitioner
  • Hartsville, SC
National Provider Identifier
1366763385
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4198 Issued in SC
Practice address
1268 S 4TH St
Hartsville, SC 29550-0703
Phone
(843) 332-3422
Fax
(843) 332-3985
NPI assigned
Jun 14, 2010
Last updated
Nov 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4198 SC Primary

Addresses

Primary practice location

1268 S 4TH St
Hartsville, SC 29550-0703

Mailing address

PO Box 1090
Hartsville, SC 29551-1090
Phone (843) 857-0111

Other identifiers 2

IdentifierTypeStateIssuer
NP1652MedicaidSC
P00906621OtherSCRAILROAD MEDICARE PTAN

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
I20100924000186 SC Practitioner - Nurse Practitioner 5092831347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caresouth Carolina Inc.Group PAC ID 1052221314, 66 clinicians

Practice addresses (Care Compare)

3080 Hwy 15-401 E
MC Coll, SC 29570-6128
Phone (843) 523-5751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4198SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Caresouth Carolina, Inc CurrentSince Jul 1, 2010 Accepting new patients
Caresouth Carolina, Inc. Current Accepting new patients
Caresouth Carolina, Inc Past Accepting new patients
Caresouth Carolina Inc Past Accepting new patients

Locations

207 E Monroe St
Dillon, SC 29536
Phone (843) 774-3736

1268 S 4th St
Hartsville, SC 29550
Phone (843) 332-3422

1268 S 4th St
Ste A
Hartsville, SC 29550
Phone (843) 332-3422

1268 S 4th St
Ste B
Hartsville, SC 29550

3080 Highway 15-401 E
Mc Coll, SC 29570
Phone (843) 523-5751

Interoperability endpoints

  • Direct secure messaging: jeri.andrews@csci.eclinicaldirectplus.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509926400000",
    "number": "1366763385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295511090",
            "telephone_number": "843-857-0111",
            "fax_number": "843-857-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 S 4TH ST",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295500703",
            "telephone_number": "843-332-3422",
            "fax_number": "843-332-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "JERI",
        "middle_name": "LYNN",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2017-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "4198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1652",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00906621",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

Verify at the official NPI Registry.