Nicole Jaquette

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1210384 Issued in PA

Practice address

3555 N Williamsburg County Hwy
Cades, SC 29518-3008

Phone

(843) 210-5000

NPI assigned

Sep 13, 2023

Last updated

Jan 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC, FL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Musc Community Physicians

  dba MUSC Community Physicians Specialty

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment NPD
• Cep America, LLC

  • Emergency Medicine Physician
  • Miramar Beach, FL
  • NPI 1295442614
  Medicare reassignment
• Musc Community Physicians

  dba MUSC Health Primary Care - Bowman

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Panama City, FL
  • NPI 1053173542
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1730966581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23321",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100874321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 N WILLIAMSBURG COUNTY HWY",
            "city": "CADES",
            "state": "SC",
            "postal_code": "295183008",
            "telephone_number": "843-210-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUETTE",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118384",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "1210384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3555 N Williamsburg County Hwy",
            "city": "Cades",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295183008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Victoria Alford, RBT
• Kamal Amirouche
• Beacon Home Care Services, LLC
• Emily Grace Gibbons, RBT
• Brandi Graham, RBT
• Stephanie Bennett Lee, FNP
• Mary's Angels Independent Living for Young Women
• Ashten McDowell, RBT
• Maggie McElveen, RBT
• Medical University Hospital Authority (MUSC Health Black River Medical Center)

• Physician Assistant in Cades, SC
• Providers in Cades, 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 Jan 10, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.