Jack E Colker, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

17721 Issued in SC

Practice address

701 Grove Rd
ER Administration
Greenville, SC 29605-5611

Phone

(864) 455-6372

NPI assigned

Apr 10, 2006

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcolker36845@direct.anmedhealth.net

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.

• Emergencymd

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  • NPI 1619383791
  NPD
• Ich ER Services, LLC

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  • NPI 1174002059

  Emergency Medicine

  NPD
• Pathology Associates of Greenville PA

  • Anatomic Pathology & Clinical Pathology Physician
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  • NPI 1831151976
  NPD
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Clinton, SC
  • NPI 1245786367
  NPD
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1649726738
  NPD
• Prisma Health-Upstate

  • Medically Fragile Infants and Children Day Care
  • Greenville, SC
  • NPI 1811439649
  NPD
• Regional Medical Center of Orangeburg and Calhoun Counties

  • Neurology Physician
  • Orangeburg, SC
  • NPI 1144940347
  NPD
• Sound Physicians Emergency Medicine of South Carolina LLC

  • Emergency Medicine Physician
  • Aiken, SC
  • NPI 1730636168

  Emergency Medicine

  NPD
• The Regional Medical Center of Orangeburg and Calhoun Counties

  • Emergency Medicine Physician
  • Bamberg, SC
  • NPI 1043656572

  Emergency Medicine

  NPD
• The Regional Medical Center of Orangeburg and Calhoun Counties

  • Emergency Medicine Physician
  • Orangeburg, SC
  • NPI 1366527566

  Emergency Medicine

  NPD
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  Emergency Medicine

  NPD
• Emergency Physician Services

  • Radiology Clinic/Center
  • Greenville, SC
  • NPI 1720471618
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1902869993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 ENTERPRISE BLVD",
            "address_2": "SUITE 250",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156300",
            "telephone_number": "864-454-0888",
            "fax_number": "864-454-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "address_2": "ER ADMINISTRATION",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055611",
            "telephone_number": "864-455-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLKER",
        "first_name": "JACK",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "17721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "57-6007863",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "930116693",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177212",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rielle Simone Coleman, MSN, PMHNP-BC
• Robert Frank Coleman, DPM
• Thomas Coleman
• William Armstrong Coleman, M.D.
• Elaine Coli
• Collaboration in Healing
• John Robert Collen, PA-C
• Hunter Alexander Collie, PHARMD
• Leigh Collier, FNP
• Thai Collier

• All providers in Greenville, SC
• Emergency Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.