Jennifer Lynn Mooneyham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

429 Roper Mountain Rd Ste B
Greenville, SC 29615-4254

Phone

(864) 331-2505

Fax

(864) 331-2510

NPI assigned

Dec 26, 2022

Last updated

Aug 10, 2026By the provider in NPPES

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

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Caroline R. Price MD PAGroup PAC ID 3779745294, 3 clinicians

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240

  SC

  Medicare reassignment Care Compare group NPD
• Caroline Price Dermatology, PA

  • Medical Specialty Clinic/Center
  • Greenville, SC
  • NPI 1730225178
  Medicare reassignment Care Compare group
• Aucc Aiken Dermatology LLC

  • Multi-Specialty Clinic/Center
  • Aiken, SC
  • NPI 1932741857
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Au Medical Center, Inc

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1437135902
  Care Compare affiliation

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

{
    "created_epoch": "1672012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1467164293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 ROPER MOUNTAIN RD STE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154254",
            "telephone_number": "864-331-2505",
            "fax_number": "864-331-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 ROPER MOUNTAIN RD STE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154254",
            "telephone_number": "864-331-2505",
            "fax_number": "864-331-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEYHAM",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-26",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Scott Moon, MD
• James Howard Moon, RT
• Jennifer Frances Moon, AA-C
• Joseph Thomas Moon, D.M.D.
• Margaret Cooper Moon, RN
• Alfred Denton Moore, M.D.
• Arthur Moore Jr., RPH
• Casey Blythe Moore, MS, ATC, SCAT
• Chloe Moore
• Claudia Moore

• Physician Assistant in Greenville, SC
• Providers in Greenville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.