Individual provider Active NPI

Jessica Demires Coleman, FNP

  • Family Nurse Practitioner
  • Easley, SC
National Provider Identifier
1669323416
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
31425 Issued in SC
Practice address
105 Franklin Square Way Ste a
Easley, SC 29642-3715
Phone
(864) 442-4110
Fax
(864) 442-4126
NPI assigned
Feb 6, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 31425 SC Primary

Addresses

Primary practice location

105 Franklin Square Way Ste a
Easley, SC 29642-3715

Mailing address

105 Franklin Square Way Ste a
Easley, SC 29642-3715
Phone (864) 442-4110

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
I20260320003318 SC Practitioner - Nurse Practitioner 9638653207 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

105 Franklin Square Way
Suite a
Easley, SC 29642-3715

350 Bedford St
Suite 406a
Stamford, CT 06901-1738

520 Wotan Rd
Columbia, SC 29229-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1770336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1669323416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 FRANKLIN SQUARE WAY STE A",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423715",
            "telephone_number": "864-442-4110",
            "fax_number": "864-442-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 FRANKLIN SQUARE WAY STE A",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423715",
            "telephone_number": "864-442-4110",
            "fax_number": "864-442-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "JESSICA",
        "middle_name": "DEMIRES",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-06",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "31425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.