Jesse Phillip Elm Jr., APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN2380 Issued in SC

Practice address

189 Serpentine Drive
Spartanburg, SC 29303

Phone

(864) 560-3280

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• South Carolina Em-I Medical Services PC

  • Emergency Medicine Physician
  • Manning, SC
  • NPI 1740725464
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1659320208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 NORTH CHURCH PLACE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293032972",
            "telephone_number": "864-489-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 SERPENTINE DRIVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29303",
            "telephone_number": "864-560-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELM",
        "first_name": "JESSE",
        "middle_name": "PHILLIP",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "APN2380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Ellis
• Mark Andrew Ellis, MD
• Paul T Ellis, MD
• Amber Lacey Ellison, RN
• Lisa Karen Ellison, BEHAVIOR INTERV.
• Margarite Helen Elsey, NP
• William Charles Elston, MD
• Embrace Therapy & Fitness
• Nkechinyere Emejuaiwe, M.D
• Emergency Physician Partners of South Carolina PLLC

• All providers in Spartanburg, SC
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.