Individual provider Active NPI

James W. Patterson, P.A.

  • Medical Physician Assistant
  • Conway, SC
National Provider Identifier
1790774651
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA1561 Issued in SC
Practice address
300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone
(843) 347-7111
NPI assigned
Oct 13, 2005
Last updated
Jun 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1561 SC Primary

Addresses

Primary practice location

300 Singleton Ridge Rd
Conway, SC 29526-9142

Mailing address

2156 Longwood Lakes Dr
Myrtle Beach, SC 29579-7529
Phone (843) 360-0067

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1561SCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fisher County Dura-Medical Equipment Co. PastSince Jan 1, 1990 Accepting new patients
Rolling Plains Physicians Office, PLLC Past Accepting new patients
Fisher County Hospital District PastSince Jan 1, 1990 Accepting new patients
Fisher County Hospital District PastSince Jan 1, 1990 Accepting new patients
Fisher County Hospital District PastSince Jan 1, 1990 Accepting new patients
Fisher County Hospital District PastSince Jan 1, 1990 Accepting new patients
Roby Rural Health Clinic PastSince Jan 1, 1990 Accepting new patients
Fisher County Hospital District PastSince Jan 1, 1990 Accepting new patients
Texas Midwest Emergency Physicians PA Past Accepting new patients
Roby Rural Health Clinic PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1790774651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2156 LONGWOOD LAKES DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295797529",
            "telephone_number": "843-360-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-347-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JAMES",
        "middle_name": "W.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "PA1561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.