NPIMap

Individual provider Active NPI

Jessica Jackson Rueb, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • West Columbia, SC
National Provider Identifier
1497199400
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianTaxonomy code 2088F0040X
License
35134272 Issued in OH
Practice address
115 Midlands CT
West Columbia, SC 29169-3456
Phone
(803) 457-7000
Fax
(803) 457-7001
NPI assigned
Apr 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician 2088F0040X 35134272 OH Primary

Addresses

Primary practice location

115 Midlands CT
West Columbia, SC 29169-3456

Mailing address

115 Midlands CT
West Columbia, SC 29169-3456
Phone (803) 312-4814

Other identifiers 1

IdentifierTypeStateIssuer
83767OtherSCU FPRS

Other names 1

  • Jessica Nicole Jackson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200405000243 SC Practitioner - Urology 9739317520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Virginia School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Urogynecology LLCGroup PAC ID 5890989875, 5 clinicians
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

115 Midlands CT
West Columbia, SC 29169-3456
Phone (803) 457-7000

1301 Taylor St
Suite 1a
Columbia, SC 29201-2946
Phone (803) 434-4790

2 Medical Park Rd
Suite 506
Columbia, SC 29203-6876
Phone (803) 540-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35134272OHMDFemale Pelvic Medicine and Reconstructive Surgery (Urology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Apr 1, 2020 Accepting new patients
Southern Urogynecology LLC Urogynecology and Reconstructive Pelvic Surgery CurrentSince Apr 10, 2023 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Apr 1, 2020 Accepting new patients
Beach Anesthesia, LLC PastSince Apr 10, 2023 Accepting new patients

Locations

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

115 Midlands Ct
West Columbia, SC 29169
Phone (803) 457-7000

Interoperability endpoints

  • Direct secure messaging: jrueb383903@direct.ghs.myhfn.org
  • Direct secure messaging: jrueb453814@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 and National Provider Directory roles.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1366416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1497199400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MIDLANDS CT",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693456",
            "telephone_number": "803-312-4814",
            "fax_number": "803-457-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MIDLANDS CT",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693456",
            "telephone_number": "803-457-7000",
            "fax_number": "803-457-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUEB",
        "first_name": "JESSICA",
        "middle_name": "JACKSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-20",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088F0040X",
            "taxonomy_group": "",
            "desc": "Urology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "OH",
            "license": "35134272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U FPRS",
            "identifier": "83767",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "JACKSON",
            "middle_name": "NICOLE",
            "credential": "JESSICA JACKSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.