Elizabeth Ann Holloway Jensen, DNP, FNP-BC,PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4350 Issued in SC

Practice address

403 Stony Landing Rd
Moncks Corner, SC 29461-3967

Phone

(843) 761-8282

Fax

(843) 761-7308

NPI assigned

Jan 25, 2006

Last updated

Oct 13, 2020By 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 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

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.

• South Carolina Dept of Mental Health Accounting Office

  dba Waccamaw Center for Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Conway, SC
  • NPI 1356397228
  Medicare reassignment NPD
• Sunrise Psychiatry LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Pleasant, SC
  • NPI 1497234223
  Medicare reassignment NPD
• South Carolina Dept of Mental Health Accounting Office

  dba Midlands Crisis Stabilization Center

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD
• South Carolina Dept of Mental Health Accounting Office

  dba Berkeley Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moncks Corner, SC
  • NPI 1508811324
  NPD

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1548230220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 STONY LANDING RD",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613967",
            "telephone_number": "843-761-8282",
            "fax_number": "843-761-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 STONY LANDING RD",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613967",
            "telephone_number": "843-761-8282",
            "fax_number": "843-761-7308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2080 Child St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322145005",
            "country_code": "US",
            "telephone_number": "904-542-7975",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "721 Long Point Rd Ste 408B",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "29464",
            "country_code": "US",
            "telephone_number": "843-800-5070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "ELIZABETH ANN",
        "middle_name": "HOLLOWAY",
        "name_prefix": "Miss",
        "credential": "DNP, FNP-BC,PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "4350",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "4350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435201",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maya Elizabeth James
• Camryn Jenkins
• Shakeitha L Jenkins
• Stevie Jenkins, RN
• Essence L Jennings, LPC-A
• Anthony Johnson
• Frances P Johnson, P.T.
• Kristi G Johnson
• Michelle Gabrielle Johnson
• Richard G. Johnson, P.T.

• Psychiatric/Mental Health Nurse Practitioner in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Psychiatric/Mental Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.