Individual provider Active NPI

Jaclyn Syms

  • Nurse Practitioner
  • Ravenel, SC
National Provider Identifier
1922906742
Registry record updated Oct 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2026095373 Issued in SC
Practice address
4146 Home Town LN
Ravenel, SC 29470-3332
Phone
(912) 656-0965
NPI assigned
Oct 30, 2026
Last updated
Oct 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2026095373 SC Primary

Addresses

Primary practice location

4146 Home Town LN
Ravenel, SC 29470-3332

Mailing address

4146 Home Town LN
Ravenel, SC 29470-3332
Phone (912) 656-0965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1793318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793318400000",
    "number": "1922906742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4146 HOME TOWN LN",
            "city": "RAVENEL",
            "state": "SC",
            "postal_code": "294703332",
            "telephone_number": "912-656-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4146 HOME TOWN LN",
            "city": "RAVENEL",
            "state": "SC",
            "postal_code": "294703332",
            "telephone_number": "912-656-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYMS",
        "first_name": "JACLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-30",
        "last_updated": "2026-10-30",
        "certification_date": "2026-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "2026095373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenel, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.