Individual provider Active NPI

Jack Parks Arthur, PA-C

  • Surgical Physician Assistant
  • Spartanburg, SC
National Provider Identifier
1922763069
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
1330 Boiling Springs Rd Ste 1600
Spartanburg, SC 29303-4219
Phone
(864) 583-2662
NPI assigned
Nov 3, 2021
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4227 SC
Physician Assistant 363A00000X SC
Surgical Physician Assistant 363AS0400X NU Primary

Addresses

Primary practice location

1330 Boiling Springs Rd Ste 1600
Spartanburg, SC 29303-4219

Mailing address

1330 Boiling Springs Rd Ste 1600
Spartanburg, SC 29303-4219
Phone (864) 582-6396

Other practice location 1

115 Deacon Tiller Ct
Duncan, SC 29334-8880
Phone (864) 583-2662

Other practice location 2

1166 Woodburn Rd
Spartanburg, SC 29302-3411
Phone (864) 426-7360

Other identifiers 2

IdentifierTypeStateIssuer
4927PAMedicaidSC
SCL8957628OtherSCMEDICARE PIN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220104002937 SC Practitioner - Physician Assistant 0143611962 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

115 Deacon Tiller CT
Duncan, SC 29334-8880
Phone (864) 582-6396

1330 Boiling Springs Rd
Suite 1600
Spartanburg, SC 29303-4219
Phone (864) 582-6396

220 Roper Mountain Rd Ext
Greenville, SC 29615-4886
Phone (864) 582-6396

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.05 of 100Reported as group
Quality
68.98
Promoting interoperability
93
Improvement activities
40
Cost
67.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4227SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Orthopaedic and Neurosurgical Associates CurrentSince Apr 1, 2024 Accepting new patients
Spartanburg Regional Med Ctr CurrentSince Dec 13, 2021 Accepting new patients
Spartanburg Medical Center CurrentSince Dec 13, 2021 Accepting new patients

Locations

115 Deacon Tiller Ct
Duncan, SC 29334
Phone (864) 582-6396

100 E Wood St
Spartanburg, SC 29303
Phone (864) 560-7070

1330 Boiling Springs Rd
Ste 1600
Spartanburg, SC 29303
Phone (864) 582-6396

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

Interoperability endpoints

  • Direct secure messaging: jack.arthur.1@26879.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1922763069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD STE 1600",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034219",
            "telephone_number": "864-582-6396",
            "fax_number": "864-249-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD STE 1600",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034219",
            "telephone_number": "864-583-2662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Deacon Tiller Ct",
            "address_purpose": "LOCATION",
            "city": "Duncan",
            "state": "SC",
            "postal_code": "293348880",
            "country_code": "US",
            "telephone_number": "864-583-2662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1166 Woodburn Rd",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293023411",
            "country_code": "US",
            "telephone_number": "864-426-7360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARTHUR",
        "first_name": "JACK",
        "middle_name": "PARKS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-03",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4227",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4927PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCL8957628",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.