NPIMap

Individual provider Active NPI

Errett Alexander Jacks, MD

  • Emergency Medicine Physician
  • Columbia, SC
National Provider Identifier
1881272680
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
86010 Issued in SC
Practice address
14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896
Phone
(803) 434-1663
Fax
(803) 434-7092
NPI assigned
Apr 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 86010 SC Primary

Addresses

Primary practice location

14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

809 82nd Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815001861 SC Practitioner - Emergency Medicine 9537566690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical University of South Carolina College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

14 Richland Medical Park Dr
Suite 350
Columbia, SC 29203-6896
Phone (803) 434-1663

Hospital & facility affiliations

  • Prisma Health Tuomey Hospital Hospital, Sumter, SC, CCN 420070
  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106
  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086
  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018

Merit-based Incentive Payment System (MIPS)

Final score
83.55 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
71.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Jul 1, 2024 Accepting new patients
Prisma Health Medical Group-Midlands Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

14 Richland Medical Park Dr
Ste 350
Columbia, SC 29203
Phone (803) 434-1663

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: errett.jacks@hca5.eclinicaldirectplus.com
  • Direct secure messaging: ejacks790065@direct.ghs.myhfn.org

Organizations & group practices 2

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 11

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": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1881272680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 350",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036896",
            "telephone_number": "803-434-1663",
            "fax_number": "803-434-7092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 82nd Pkwy",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295724607",
            "country_code": "US",
            "telephone_number": "843-692-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKS",
        "first_name": "ERRETT",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "86010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.