Active NPI
Jessica Cruz, LPN
- Licensed Practical Nurse
- Ridgeland, SC
National Provider Identifier
1710857123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 54453
- Practice address
- 124 Boardwalk Dr Ste a
Ridgeland, SC 29936-7994 - Phone
- (843) 645-2770
- NPI assigned
- Nov 10, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 54453 | SC | Primary |
Addresses
Primary practice location
124 Boardwalk Dr Ste a
Ridgeland, SC 29936-7994
Mailing address
102 Saluda Way
Beaufort, SC 29906-6043
Phone (843) 441-8492
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54453 | SC | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recovery Concepts LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Methadone Clinic
- Ridgeland, SC
- NPI 1760596746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762732800000",
"number": "1710857123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 SALUDA WAY",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299066043",
"telephone_number": "843-441-8492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 BOARDWALK DR STE A",
"city": "RIDGELAND",
"state": "SC",
"postal_code": "299367994",
"telephone_number": "843-645-2770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "JESSICA",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-10",
"last_updated": "2025-11-10",
"certification_date": "2025-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "SC",
"license": "54453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgeland, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.