NPIMap

Individual provider Active NPI

Jennifer O Gillis, NP-C

  • Primary Care Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1407195688
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
18120 Issued in SC
Practice address
4540 Trenholm Rd
Columbia, SC 29206-4462
Phone
(803) 790-4700
Fax
(803) 790-6130
NPI assigned
Feb 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 18120 SC Primary

Addresses

Primary practice location

4540 Trenholm Rd
Columbia, SC 29206-4462

Mailing address

PO Box 6069
West Columbia, SC 29171-6069

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgillis14879@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130409000093 SC Practitioner - Nurse Practitioner 0547406936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

4540 Trenholm Rd
Columbia, SC 29206-4462
Phone (803) 790-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc Current Accepting new patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

5115 Forest Dr
Ste 100
Columbia, SC 29206
Phone (803) 790-4700

4540 Trenholm Rd
Columbia, SC 29206
Phone (803) 254-3501

811 W Main St
Ste 209
Lexington, SC 29072
Phone (803) 314-9729

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

811 W Main St
Ste 201
Lexington, SC 29072
Phone (803) 358-6220

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

Interoperability endpoints

  • Direct secure messaging: jgillis14879@direct.lexmed.com

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 10

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": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1407195688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 TRENHOLM RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292064462",
            "telephone_number": "803-790-4700",
            "fax_number": "803-790-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "JENNIFER",
        "middle_name": "O",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-07",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SC",
            "license": "18120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgillis14879@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "4540 Trenholm Rd",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292064462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.