Individual provider Active NPI

Anna Smith Jeffries, PA-C

  • Physician Assistant
  • North Charleston, SC
National Provider Identifier
1639878580
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4676 Issued in SC
Practice address
5401 Netherby LN
North Charleston, SC 29420-7363
Phone
(843) 872-3015
NPI assigned
Feb 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4676 SC Primary

Addresses

Primary practice location

5401 Netherby LN
North Charleston, SC 29420-7363

Mailing address

353 Spoonbill LN
Mount Pleasant, SC 29464-2835

Other names 1

  • Anna Catherine Smith Former name

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
I20240809002129 SC Practitioner - Physician Assistant 6800334715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Dermatology PCGroup PAC ID 6709164056, 11 clinicians

Practice addresses (Care Compare)

5401 Netherby LN
Suite 1202
North Charleston, SC 29420-7365
Phone (843) 872-3015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4676SCMDSpeech-Language Pathologist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1639878580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 SPOONBILL LN",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294642835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 NETHERBY LN",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294207363",
            "telephone_number": "843-872-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "ANNA",
        "middle_name": "SMITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "SMITH",
            "middle_name": "CATHERINE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.