NPIMap

Individual provider Active NPI

Jessica Forry Lebrun, PA-C

  • Physician Assistant
  • Spartanburg, SC
National Provider Identifier
1730754375
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4060 Issued in SC
Practice address
101 E Wood St
Spartanburg, SC 29303-3040
Phone
(864) 560-5444
Fax
(864) 560-6017
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 4060 SC Primary

Addresses

Primary practice location

101 E Wood St
Spartanburg, SC 29303-3040

Mailing address

104 Vesper Cir
Mauldin, SC 29662-2520
Phone (864) 560-5444

Other practice location 1

14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896
Phone (803) 434-1663

Other names 1

  • Jessica Forry Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211027003292 SC Practitioner - Physician Assistant 0042608838 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4060SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Oct 11, 2021 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Oct 11, 2021 Accepting new patients
Pelham Medical Center CurrentSince Jan 1, 2025 Accepting new patients
Pelham Medical Center CurrentSince Jan 1, 2025 Accepting new patients
Prisma Health University Medical Group CurrentSince Oct 11, 2021 Accepting new patients
Spartanburg Medical Center CurrentSince Jan 1, 2025 Accepting new patients
Prisma Health University Medical Group CurrentSince Oct 11, 2021 Accepting new patients
Spartanburg Medical Center CurrentSince Jan 1, 2025 Accepting new patients
Village Hospital Past Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

14 Richland Medical Park Dr
Ste 350
Columbia, SC 29203
Phone (803) 434-1663

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Interoperability endpoints

  • Direct secure messaging: jforry527017@direct.ghs.myhfn.org

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1730754375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 VESPER CIR",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622520",
            "telephone_number": "864-560-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WOOD ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033040",
            "telephone_number": "864-560-5444",
            "fax_number": "864-560-6017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Richland Medical Park Dr Ste 350",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036896",
            "country_code": "US",
            "telephone_number": "803-434-1663",
            "fax_number": "803-434-3894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBRUN",
        "first_name": "JESSICA",
        "middle_name": "FORRY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "FORRY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.