Individual provider Active NPI

Jane Elizabeth Whiteside, NP

  • Nurse Practitioner
  • Bishopville, SC
National Provider Identifier
1740484757
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN3220 Issued in SC
Practice address
545 Sumter Hwy
Bishopville, SC 29010-7601
Phone
(803) 484-5317
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN3220 SC Primary

Addresses

Primary practice location

545 Sumter Hwy
Bishopville, SC 29010-7601

Mailing address

545 Sumter Hwy
Bishopville, SC 29010-7601
Phone (803) 484-5317

Other identifiers 2

IdentifierTypeStateIssuer
P00906571OtherSCRAILROAD MEDICARE PTAN
NP1114MedicaidSC

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
I20070924000511 SC Practitioner - Nurse Practitioner 7719071554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Carolina School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caresouth Carolina Inc.Group PAC ID 1052221314, 66 clinicians

Practice addresses (Care Compare)

545 Sumter Hwy
Bishopville, SC 29010-7601
Phone (803) 484-5317

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN3220SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caresouth Carolina, Inc. CurrentSince Jul 1, 2010 Accepting new patients
Caresouth Carolina, Inc. Current Accepting new patients
Caresouth Carolina, Inc Past Accepting new patients
Caresouth Carolina, Inc Past Accepting new patients

Locations

545 Sumter Hwy
Bishopville, SC 29010
Phone (803) 484-5317

1268 S 4th St
Hartsville, SC 29550
Phone (843) 332-3422

Interoperability endpoints

  • Direct secure messaging: jane.whiteside@csci.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1740484757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 SUMTER HWY",
            "city": "BISHOPVILLE",
            "state": "SC",
            "postal_code": "290107601",
            "telephone_number": "803-484-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 SUMTER HWY",
            "city": "BISHOPVILLE",
            "state": "SC",
            "postal_code": "290107601",
            "telephone_number": "803-484-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESIDE",
        "first_name": "JANE",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "APRN3220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00906571",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1114",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bishopville, SC

Sources for this page

Verify at the official NPI Registry.