Jacqueline Eckert Nichols, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1624 Issued in SC

Practice address

48 Folly Road Blvd
Charleston, SC 29407-7507

Phone

(843) 769-2100

Fax

(843) 769-0230

NPI assigned

Feb 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Jacquline Lee Eckert Former name

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

Medical University of South Carolina College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Perry Dermatology and DermatopathologyGroup PAC ID 6800129271, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Perry Dermatology and Dermatopathology

  dba Perry Dermatology

  • Dermatology Physician
  • Charleston, SC
  • NPI 1740746429
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1298246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1689971079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 FOLLY ROAD BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077507",
            "telephone_number": "843-769-2100",
            "fax_number": "843-769-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 FOLLY ROAD BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077507",
            "telephone_number": "843-769-2100",
            "fax_number": "843-769-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JACQUELINE",
        "middle_name": "ECKERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-21",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "8003",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1624",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQULINE",
            "last_name": "ECKERT",
            "middle_name": "LEE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• NHC Place-Charleston LLC
• Madison Lynn Nicely, RBT
• Nicholas a Straney DPM
• Casey Michelle Nichols, FNP
• Erin Lewis Nichols, D.M.D.
• Virginia Guest Nichols, MD
• Lori Carroll Nicholson, PT
• Oana M Nicoara, MD
• Ashish Nicodemus, MD
• Nicole Eagle, Bcba

• Medical Physician Assistant in Charleston, SC
• Providers in Charleston, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; 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.