Jacklyn Pearson Wurthmann, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3091 Issued in SC

Practice address

306 Station 22 1/2 St
Sullivans Island, SC 29482-9756

Phone

(843) 883-3176

NPI assigned

Sep 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Roper Saint Francis Physicians NetworkGroup PAC ID 5193874824, 530 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Pleasant Hospital Hospital, Mount Pleasant, SC, CCN 420104
• Roper Hospital Hospital, Charleston, SC, CCN 420087
• Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065
• Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaclyn.wurthmann@rsfpp.eclinicaldirectplus.com
• Direct secure messaging: jwurthmann1236548@direct.bsmhealth.org

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.

• Roper Saint Francis Physicians Network

  • Surgery Physician
  • Charleston, SC
  • NPI 1124431606
  Medicare reassignment Care Compare group
• Roper Saint Francis Physicians Network

  • Obstetrics & Gynecology Physician
  • Charleston, SC
  • NPI 1811857352
  NPD
• Roper Saint Francis Physicians Network

  • Internal Medicine Physician
  • Charleston, SC
  • NPI 1013158187
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bon Secours St. Francis Xavier Hospital Inc.

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1851361778
  Care Compare affiliation
• Roper Hospital, Inc

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1962472860
  Care Compare affiliation
• Roper St Francis Hospital-Berkeley Inc.

  • General Acute Care Hospital
  • Summerville, SC
  • NPI 1336603646
  Care Compare affiliation
• Roper St. Francis Mount Pleasant Hospital

  • General Acute Care Hospital
  • Mt Pleasant, SC
  • NPI 1255645644
  Care Compare affiliation

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1679057541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 STATION 22 1/2 ST",
            "city": "SULLIVANS ISLAND",
            "state": "SC",
            "postal_code": "294829756",
            "telephone_number": "843-883-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURTHMANN",
        "first_name": "JACKLYN",
        "middle_name": "PEARSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3876PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jaclyn.Wurthmann@rsfpp.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Document and CCD Exchange",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient Care Documents",
            "address_1": "306 Station 22 1/2 St",
            "city": "Sullivans Island",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294829756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rochelle C Rutledge, M.D.
• Darragh Miller Simon, LMT
• Sports Plus
• Danielle Stunzi, FDNP
• McKenzie Ann West

• Physician Assistant in Sullivans Island, SC
• Providers in Sullivans Island, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.