Jack A. Stansbury Jr., NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19033 Issued in SC

Practice address

1 Pinckney Blvd
Beaufort, SC 29902-6122

Phone

(843) 228-5600

NPI assigned

Aug 28, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Patient First Richmond Medical Group PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1689603748
  Medicare reassignment NPD
• Patient First Richmond Medical Group PLLC

  • Urgent Care Clinic/Center
  • Fairfax, VA
  • NPI 1588018881
  NPD

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1508014853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PINCKNEY BLVD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026122",
            "telephone_number": "843-228-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PINCKNEY BLVD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026122",
            "telephone_number": "843-228-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANSBURY",
        "first_name": "JACK",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19033",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP05772",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4330",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ralee Spooner, DMD
• Paige Amsler Sprietsma, ANP
• James D Spruill, RPH
• Mary St.John, M.D.
• Andrew John Stag
• Emily M Stansell, PHARMD
• State of South Carolina
• Trenton K Statler, DPM
• Spenser M Staub, MD
• Lori Stec

• Family Nurse Practitioner in Beaufort, SC
• Providers in Beaufort, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.