Individual provider Active NPI

Patrick John Jebaily, M.D.

  • Family Medicine Physician
  • Florence, SC
National Provider Identifier
1649432428
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30966 Issued in SC
Practice address
800 E Cheves St
Suite 310
Florence, SC 29506-2650
Phone
(843) 679-7272
Fax
(843) 679-7215
NPI assigned
Jul 2, 2008
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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 30966 SC Primary

Addresses

Primary practice location

800 E Cheves St
Suite 310
Florence, SC 29506-2650

Mailing address

P.O. Box 3239
Florence, SC 29502-3239
Phone (843) 777-7042

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address patrick.jebaily@mpaii.eclinicaldirectplus.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110404000189 SC Practitioner - Family Practice 7517141369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

800 E Cheves St
Suite 310
Florence, SC 29506-2652
Phone (843) 679-7272

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II CurrentSince Jul 1, 2011 Accepting new patients
McLeod Physician Associates II Family Medicine Current Accepting new patients
McLeod Physician Associates II CurrentSince Jul 1, 2011 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc. Past Accepting new patients

Locations

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 310
Florence, SC 29506
Phone (843) 679-7272

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

Interoperability endpoints

  • Direct secure messaging: patrick.jebaily@mpaii.eclinicaldirectplus.com
  • Direct secure messaging: pjebaily27960@directmcleodehealth.org

Organizations & group practices 5

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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1649432428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-777-7042",
            "fax_number": "843-777-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CHEVES ST",
            "address_2": "SUITE 310",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062650",
            "telephone_number": "843-679-7272",
            "fax_number": "843-679-7215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEBAILY",
        "first_name": "PATRICK",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "30966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "patrick.jebaily@mpaii.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "ECW DA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "800 E Cheves St",
            "address_2": "Suite 310",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295062650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.