Individual provider Active NPI

Jared Dean Phillips, DO

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1588125579
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
83729 Issued in SC
Practice address
2270 Ashley Crossing Dr Ste 135
Charleston, SC 29414-6175
Phone
(843) 556-7942
Fax
(843) 556-7946
NPI assigned
Mar 31, 2019
Last updated
Oct 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 83729 SC Primary

Addresses

Primary practice location

2270 Ashley Crossing Dr Ste 135
Charleston, SC 29414-6175

Mailing address

PO Box 632516
Cincinnati, OH 45263-2516
Phone (888) 472-0043

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210910001735 FL Order and Referring Only - Family PracticePractitioner - Family Practice 1759787070

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDO.83729SCMDAerospace Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1588125579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632516",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632516",
            "telephone_number": "888-472-0043",
            "fax_number": "513-653-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 ASHLEY CROSSING DR STE 135",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146175",
            "telephone_number": "843-556-7942",
            "fax_number": "843-556-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JARED",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-31",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "83729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.