Individual provider Active NPI

Jennifer Rae Stogsdill, PA-C

  • Medical Physician Assistant
  • Summerville, SC
National Provider Identifier
1548924079
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4186 Issued in SC
Practice address
1203 Old Trolley Rd Ste B
Summerville, SC 29485-5296
Phone
(843) 998-3030
NPI assigned
Oct 30, 2021
Last updated
May 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4186 SC
Medical Physician Assistant 363AM0700X 4186 SC Primary

Addresses

Primary practice location

1203 Old Trolley Rd Ste B
Summerville, SC 29485-5296

Mailing address

1203 Old Trolley Rd. Ste B
Summerville, SC 29485-8205
Phone (843) 998-3030

Other identifiers 1

IdentifierTypeStateIssuer
5009PAMedicaidSC

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
I20220223002325 SC Practitioner - Physician Assistant 0941694699

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
52.78 of 100Reported as group
Quality
55.48
Improvement activities
0
Cost
74.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1635552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1548924079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 OLD TROLLEY RD. STE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858205",
            "telephone_number": "843-998-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 OLD TROLLEY RD STE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855296",
            "telephone_number": "843-998-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOGSDILL",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-30",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4186",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "4186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5009PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.