Individual provider Active NPI

Jeremy Chad Stiles, NP-C

  • Acute Care Nurse Practitioner
  • West Columbia, SC
National Provider Identifier
1669628608
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
23553 Issued in SC
Practice address
2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone
(803) 791-2000
NPI assigned
Aug 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.0500406-CR OH
Professional Counselor 101YP2500X C.0500406-CR OH
Family Nurse Practitioner 363LF0000X 23553 SC
Acute Care Nurse Practitioner 363LA2100X 23553 SC Primary

Addresses

Primary practice location

2720 Sunset Blvd
West Columbia, SC 29169-4810

Mailing address

PO Box 6069
West Columbia, SC 29171-6069

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jstiles30766@direct.lexmed.com

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
I20200213001030 SC Practitioner - Nurse Practitioner 7618303504 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2350

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C.0500406-CROHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc Current Accepting new patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Lowcountry Urgent Care LLC CurrentSince Jul 15, 2020 Accepting new patients
Lexington County Health Services District, Inc. CurrentSince Jan 13, 2020 Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

182C Sea Island Pkwy
Beaufort, SC 29907
Phone (843) 322-1933

1111 Knox Abbott Dr
Cayce, SC 29033
Phone (803) 314-0660

557 Columbia Ave
Chapin, SC 29036
Phone (803) 932-0655

3016 Longtown Commons Dr
Ste 100
Columbia, SC 29229
Phone (803) 314-0500

7035 Saint Andrews Rd
Columbia, SC 29212
Phone (803) 749-0924

338 E Columbia Ave
Leesville, SC 29070
Phone (803) 332-4300

811 W Main St
Lexington, SC 29072

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

154 Saluda Pointe Dr
Lexington, SC 29072
Phone (803) 785-3580

811 W Main St
Ste 212
Lexington, SC 29072
Phone (803) 358-6180

935 W 2nd St
Swansea, SC 29160
Phone (803) 568-2000

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

470 Hulon Ln
West Columbia, SC 29169

Organizations & group practices 7

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.

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": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1669628608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694810",
            "telephone_number": "803-791-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES",
        "first_name": "JEREMY",
        "middle_name": "CHAD",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-11",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.0500406-CR",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.0500406-CR",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23553",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "23553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstiles30766@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2720 Sunset Blvd",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.