Jessica Vanessa Romero, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

15539 Issued in PR

Practice address

3381 Phillis Blvd
Myrtle Beach, SC 29577-1560

Phone

(843) 577-7011

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1427168376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3381 PHILLIS BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771560",
            "telephone_number": "843-577-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3381 PHILLIS BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771560",
            "telephone_number": "843-577-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "JESSICA",
        "middle_name": "VANESSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMC M MEDICARE CHOICE",
            "identifier": "3953",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "0022929RO",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "7380082",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENONITA",
            "identifier": "M000611",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Olsen Rojek, PA-C
• Amanda Elizabeth Roldan
• Catie R Rollins
• Roman Clinical Consulting, LLC
• John Anthony Roman II, LISW-CP
• Ronald Cassidy LPC
• Amy Root, RN
• Rooted in Care LLC
• Roots North Wings South LLC
• Eileen Stephanie Tokarz Roque

• General Practice Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• General Practice Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.

Verify at the official NPI Registry.