Individual provider Active NPI

Jillian Abigail Benton, FNP-BC

  • Nurse Practitioner
  • Myrtle Beach, SC
National Provider Identifier
1619772233
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
31193 Issued in SC
Practice address
1021 Cipriana Dr Ste 250
Myrtle Beach, SC 29572-4621
Phone
(843) 895-2120
NPI assigned
Feb 17, 2025
Last updated
Oct 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 31193 SC Primary

Addresses

Primary practice location

1021 Cipriana Dr Ste 250
Myrtle Beach, SC 29572-4621

Mailing address

1021 Cipriana Dr Ste 250
Myrtle Beach, SC 29572-4621
Phone (843) 895-2120

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
I20260120002396 SC Practitioner - Nurse Practitioner 5991282147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1021 Cipriana Dr
Suite 250
Myrtle Beach, SC 29572-4621

PO Box
Suite 500
Holly Springs, NC 27540-0500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Shores Urogynecology and Pelvic Reconstructive Surgery PC CurrentSince Dec 7, 2025 Accepting new patients

Locations

1021 Cipriana Dr
Ste 250
Myrtle Beach, SC 29572
Phone (843) 421-8200

Interoperability endpoints

  • Direct secure messaging: jillian.benton.1@28116.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1619772233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 CIPRIANA DR STE 250",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724621",
            "telephone_number": "843-895-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 CIPRIANA DR STE 250",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724621",
            "telephone_number": "843-895-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTON",
        "first_name": "JILLIAN",
        "middle_name": "ABIGAIL",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "31193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.