William Russell Jennings Jr., MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

24096 Issued in SC

Practice address

5 Medical Park Drive
Ste 350 Palmetto Health Richland Dept of Emergency Med
Columbia, SC 29203

Phone

(803) 434-6690

Fax

(803) 434-3946

NPI assigned

Mar 22, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bamberg County Memorial Hospital

  • Rural Acute Care Hospital
  • Bamberg, SC
  • NPI 1124051834
  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1508825035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PARK DRIVE",
            "address_2": "DEPT OF EMERGENCY MEDICINE PALMETTO HEALTH RICHLAND",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-6690",
            "fax_number": "803-434-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PARK DRIVE",
            "address_2": "STE 350 PALMETTO HEALTH RICHLAND DEPT OF EMERGENCY MED",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-6690",
            "fax_number": "803-434-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "WILLIAM",
        "middle_name": "RUSSELL",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "24096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240965",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mahogony Jennings
• Ned Jennings, DMD
• Nicole D Jennings, HAIR LOSS SPECIALIST
• Shamea Jennings, BEHAVIOR TECHNICIAN
• Shelby Brooke Jennings, OT
• Jennys Angels
• Kristian Ardis Jensen, PHARMD
• Nathaniel Paul Jensen, O.D.
• Mariana Carmen Jeong, PA-C
• Shanta Avalice Jerideau, LPC

• Emergency Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Emergency Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.