Mary Jill Haynie Cleary, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APN2085 Issued in SC

Practice address

109 Bee St
Charleston, SC 29401-5703

Phone

(843) 577-5011

NPI assigned

Jun 26, 2007

Last updated

Feb 23, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jill H Cleary Professional name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Carolina Family Care, Inc

  dba MUSC Physicians PCP

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1184655722
  Medicare reassignment NPD
• Carolina Family Care, Inc

  dba MUSC Physicians Coosaw Internal Medicine

  • Internal Medicine Physician
  • North Charleston, SC
  • NPI 1649533662
  Medicare reassignment NPD
• Carolina Family Care Inc

  dba MUSC Physicians PCP

  • Family Medicine Physician
  • North Charleston, SC
  • NPI 1194152272
  NPD
• Carolina Family Care, Inc

  dba MUSC Physicians PCP West Ashley

  • Multi-Specialty Clinic/Center
  • Charleston, SC
  • NPI 1518931682
  NPD

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1902002900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BEE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294015703",
            "telephone_number": "843-577-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BEE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294015703",
            "telephone_number": "843-577-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8992 University Blvd",
            "address_purpose": "LOCATION",
            "city": "North Charleston",
            "state": "SC",
            "postal_code": "294068104",
            "country_code": "US",
            "telephone_number": "843-876-6555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNIE CLEARY",
        "first_name": "MARY JILL",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "APN2085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "AA05637189",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "CLEARY",
            "middle_name": "H",
            "credential": "ANP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Julie Ivester Hayler, APRN
• Kathryn Hayne, PT, DPT
• Elizabeth Haynes, MSW LMSW
• Hwajoo Haynes, MSN, ANP, BC, APRN
• Louise Haynes
• Solomon Hayon, MD
• Kimberly Lynne Hays, M.D.
• Lisa Hays
• Hannah Hayward, MD
• Linh T Hazard

• Adult Health Nurse Practitioner in Charleston, SC
• Providers in Charleston, SC by specialty
• Adult Health Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.

Verify at the official NPI Registry.