Jamison Scott Bottomley, PHD
Individual provider Active NPI Clinical Psychologist · Charleston, SC
NPI 1891485751 · NPPES record last updated May 12, 2023
Key facts
- NPI
- 1891485751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1771 (SC)
- Practice address
- 67 President St, MSC 861
2ND Floor Iop South BLDG
Charleston, SC 29425 - Phone
- (843) 792-8209
- NPI assigned
- May 12, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.02 of 100
- Quality
- 62.41
- Promoting interoperability
- 99
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230703003089 | SC | Practitioner - Clinical Psychologist | 0941669386 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1771 | SC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Associates of the Medical University of South Carol | Current |
Accepting new patients |
Locations
171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1771 | SC | Yes |
Addresses
Primary practice location
67 President St, MSC 861
2ND Floor Iop South BLDG
Charleston, SC 29425
Mailing address
421 Wappoo Rd
Charleston, SC 29407-6864
Phone (714) 766-9827
Other providers in Charleston, SC
- Rebekah Fay Boss
- Allison Claire Bossong
- Hayley Bucknum Bost
- Brittany Barefoot Bostic
- Emily Ryan Bott
- Kathryn Ann Bottonari
- Peter Elliott Botzis
- Gregory Boucher
- Noelle Paige Boudreau
- Lauren Boudreaux
All providers in Charleston, SC · Clinical Psychologist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.