Individual provider Active NPI

Amy Ellen Jamison, M.D., M.B.A.

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
National Provider Identifier
1790919876
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
51557 Issued in SC
Practice address
1690 Skylyn Dr Ste 300a
Spartanburg, SC 29307-1022
Phone
(864) 342-4000
Fax
(864) 596-7409
NPI assigned
May 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD445794 PA
Physical Medicine & Rehabilitation Physician 208100000X 51557 SC Primary

Addresses

Primary practice location

1690 Skylyn Dr Ste 300a
Spartanburg, SC 29307-1022

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other practice location 1

879 Hospital Rd
Indiana, PA 15701-3629
Phone (724) 357-8367

Other identifiers 4

IdentifierTypeStateIssuer
SCC130OtherSCMEDICARE PIN
102715003MedicaidPA
SCC1305019OtherSCMEDICARE PIN
515570MedicaidSC

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
Master of Business Administration, Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1790919876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 SKYLYN DR STE 300A",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071022",
            "telephone_number": "864-342-4000",
            "fax_number": "864-596-7409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "879 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Indiana",
            "state": "PA",
            "postal_code": "157013629",
            "country_code": "US",
            "telephone_number": "724-357-8367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMISON",
        "first_name": "AMY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.,  M.B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD445794",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SC",
            "license": "51557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCC130",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102715003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCC1305019",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "515570",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; 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.