Individual provider Active NPI

Jane Mansfield, REGISTERED NURSE

  • Community Health Registered Nurse
  • Conway, SC
National Provider Identifier
1417374216
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
R92661 Issued in SC
Practice address
112 Regency Dr
Conway, SC 29526-9018
Phone
(843) 234-0412
NPI assigned
Mar 19, 2014
Last updated
Mar 19, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X R92661 SC Primary

Addresses

Primary practice location

112 Regency Dr
Conway, SC 29526-9018

Mailing address

1705 W Evans St
Florence, SC 29501-3331
Phone (843) 661-4762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R92661SCMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1417374216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 W EVANS ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013331",
            "telephone_number": "843-661-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 REGENCY DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269018",
            "telephone_number": "843-234-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSFIELD",
        "first_name": "JANE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-19",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "SC",
            "license": "R92661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.