Active NPI
Jacob Charles Andrews, DO
- Pediatrics Physician
- Hendersonville, NC
National Provider Identifier
1861066367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 202401845
- Practice address
- 600 Beverly Hanks Ctr
Hendersonville, NC 28792-2305 - Phone
- (828) 693-3296
- NPI assigned
- May 18, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | LL83629 | SC | |
| Pediatrics Physician | 208000000X | 202401845 | NC | Primary |
Addresses
Primary practice location
600 Beverly Hanks Ctr
Hendersonville, NC 28792-2305
Mailing address
Prisma Health Children'S Hospital Outpatient Center
14 Medical Park, Ste 400
Columbia, SD 29203
Phone (803) 434-6155
Other practice location 1
Prisma Health Children's Hospital Outpatient Center
14 Medical Park, Ste 400
Columbia, SC 29203
Phone (803) 434-6155
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210809003732 | SC | Order and Referring Only - Pediatric Medicine | 7719381029 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202401845 | NC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722816000000",
"number": "1861066367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PRISMA HEALTH CHILDREN'S HOSPITAL OUTPATIENT CENTER",
"address_2": "14 MEDICAL PARK, STE 400",
"city": "COLUMBIA",
"state": "SD",
"postal_code": "29203",
"telephone_number": "803-434-6155",
"fax_number": "803-434-6979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 BEVERLY HANKS CTR",
"city": "HENDERSONVILLE",
"state": "NC",
"postal_code": "287922305",
"telephone_number": "828-693-3296"
}
],
"practiceLocations": [
{
"address_1": "Prisma Health Children's Hospital Outpatient Center",
"address_2": "14 Medical Park, Ste 400",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "29203",
"country_code": "US",
"telephone_number": "803-434-6155",
"fax_number": "803-434-6979",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDREWS",
"first_name": "JACOB",
"middle_name": "CHARLES",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-18",
"last_updated": "2024-08-05",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "LL83629",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "202401845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hendersonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.