Individual provider Active NPI

Jamison McKenzie Moran

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1407601685
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN259143 Issued in GA
Practice address
111 Doctor Cir
Columbia, SC 29203-6502
Phone
(800) 491-0909
NPI assigned
Apr 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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 RN259143 GA Primary

Addresses

Primary practice location

111 Doctor Cir
Columbia, SC 29203-6502

Mailing address

111 Doctor Cir
Columbia, SC 29203-6502
Phone (800) 491-0909

Other practice location 1

304 N Westberry St
Sylvester, GA 31791-2125
Phone (229) 463-7071

Other practice location 2

605 SW Central Ave
Blackshear, GA 31516-2269
Phone (912) 387-6298

Other practice location 3

140 Martin Palmer Dr
Brunswick, GA 31523-8285
Phone (912) 567-6660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20241226001923 GA Practitioner - Nurse Practitioner 8820525157 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Access Medical Clinic Georgia LLCGroup PAC ID 2961814694, 23 clinicians
SC House Calls IncGroup PAC ID 6800994807, 445 clinicians
Chronic Disease Management of Georgia LLCGroup PAC ID 7618306721, 76 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

304 N Westberry St
Sylvester, GA 31791-2125
Phone (229) 463-7071

624 Ellis St
Augusta, GA 30901-1434
Phone (800) 491-0909

704 Breedlove Dr
Suite a
Monroe, GA 30655-2054
Phone (888) 772-0076

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN259143GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chronic Disease Management of Georgia, LLC CurrentSince Sep 20, 2024 Accepting new patients

Locations

704 Breedlove Dr
#A
Monroe, GA 30655
Phone (888) 772-0076

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1407601685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 N Westberry St",
            "address_purpose": "LOCATION",
            "city": "Sylvester",
            "state": "GA",
            "postal_code": "317912125",
            "country_code": "US",
            "telephone_number": "229-463-7071",
            "fax_number": "229-463-7081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "605 SW Central Ave",
            "address_purpose": "LOCATION",
            "city": "Blackshear",
            "state": "GA",
            "postal_code": "315162269",
            "country_code": "US",
            "telephone_number": "912-387-6298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "140 Martin Palmer Dr",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "GA",
            "postal_code": "315238285",
            "country_code": "US",
            "telephone_number": "912-567-6660",
            "fax_number": "833-606-0577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "JAMISON",
        "middle_name": "MCKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN259143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.