Individual provider Active NPI

Jennifer H Carter, PA

  • Medical Physician Assistant
  • Lugoff, SC
National Provider Identifier
1477658987
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1128 Issued in SC
Practice address
710 Dewitt Dr
Lugoff, SC 29078-9069
Phone
(803) 438-7566
Fax
(803) 438-4371
NPI assigned
Sep 13, 2006
Last updated
Aug 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1128 SC Primary

Addresses

Primary practice location

710 Dewitt Dr
Lugoff, SC 29078-9069

Mailing address

PO Box 1259
Sentinel Health Partners PA Business Office
Camden, SC 29021-1259
Phone (803) 713-8350

Other identifiers 3

IdentifierTypeStateIssuer
0477PAMedicaidSC
192417OtherMEDCOST PIN
P00371643OtherSCRAILROAD MEDICARE PIN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061113000323 SC Practitioner - Physician Assistant 3577561281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1128SCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Aug 1, 2021 Accepting new patients
Musc Community Physicians CurrentSince Aug 1, 2021 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1344 Haile St
Camden, SC 29020
Phone (803) 254-3376

2001 Laurel St
Ste 300
Columbia, SC 29204
Phone (803) 254-2786

710 Dewitt Dr
Lugoff, SC 29078
Phone (803) 233-1730

Interoperability endpoints

  • Direct secure messaging: jcarter379648@direct.musc.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1477658987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1259",
            "address_2": "SENTINEL HEALTH PARTNERS PA BUSINESS OFFICE",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290211259",
            "telephone_number": "803-713-8350",
            "fax_number": "803-713-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 DEWITT DR",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290789069",
            "telephone_number": "803-438-7566",
            "fax_number": "803-438-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "JENNIFER",
        "middle_name": "H",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0477PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST PIN",
            "identifier": "192417",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00371643",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lugoff, SC

Sources for this page

Verify at the official NPI Registry.