Jalen Maxell Manor, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

23652 Issued in SC

Practice address

10 Pope Ave
Hilton Head, SC 29928-4719

Phone

(843) 785-7786

NPI assigned

Jan 31, 2020

Last updated

Mar 30, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, GA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

University of South Carolina School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lowcountry Urgent Care LLCGroup PAC ID 9739210337, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Lowcountry Urgent Care LLC

  dba Lowcountry Urgent Care

  • Primary Care Nurse Practitioner
  • Beaufort, SC
  • NPI 1326364100
  Medicare reassignment Care Compare group
• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1932730694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 POPE AVE",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299284719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 POPE AVE",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299284719",
            "telephone_number": "843-785-7786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5690 Ogeechee Rd",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314059500",
            "country_code": "US",
            "telephone_number": "912-234-5575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANOR",
        "first_name": "JALEN",
        "middle_name": "MAXELL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-31",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP000666",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Mackay-Pearson, LPC
• Linda J Magid, PTA
• Main Street Chiropractic of Hilton Head, Inc.
• Main Street Health Center LLC
• Main Street Medical PC
• Lourdes Martinez
• Match Point Hilton Head LLC (Synergy HomeCare of the Lowcountry)
• Matthew Mastrorocco DMD, PA
• David E Maurer, M.D.
• Mayes Internal Medicine, LLC

• Family Nurse Practitioner in Hilton Head, SC
• Providers in Hilton Head, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.