Individual provider Active NPI

Jessica Marie Shearer, NNP

  • Neonatal Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1730613779
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
26094 Issued in SC
Practice address
316 Calhoun St
Charleston, SC 29401-1113
Phone
(843) 402-1638
Fax
(843) 724-2455
NPI assigned
Apr 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 119835 AK
Neonatal Nurse Practitioner 363LN0000X 26094 SC Primary

Addresses

Primary practice location

316 Calhoun St
Charleston, SC 29401-1113

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other practice location 1

171 Ashley Ave
Charleston, SC 29425-4615
Phone (843) 792-1414

Other identifiers 1

IdentifierTypeStateIssuer
NP8670MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

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
I20230526000599 SC Practitioner - Nurse Practitioner 5698045169 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
119835AKMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince May 8, 2023 Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network CurrentSince May 8, 2023 Accepting new patients
Roper St. Francis Specialty Physicians CurrentSince Feb 1, 2026 Accepting new patients
University Medical Associates of the Medical University of South Carol Past Accepting new patients

Locations

2097 Henry Tecklenburg Dr
Ste 311W
Charleston, SC 29414
Phone (843) 402-1084

2097 Henry Tecklenburg Dr
Ste 211W
Charleston, SC 29414
Phone (843) 958-2555

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1730613779",
    "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",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 CALHOUN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011113",
            "telephone_number": "843-402-1638",
            "fax_number": "843-724-2455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294254615",
            "country_code": "US",
            "telephone_number": "843-792-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AK",
            "license": "119835",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "SC",
            "license": "26094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP8670",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "171 Ashley Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294254615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.