Individual provider Active NPI

Jammie Emerson, NP-C

  • Family Nurse Practitioner
  • Myrtle Beach, SC
National Provider Identifier
1952833279
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20864 Issued in SC
Practice address
8203 Nigels Dr
Myrtle Beach, SC 29572-4177
Phone
(843) 491-1630
NPI assigned
Mar 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20864 SC Primary

Addresses

Primary practice location

8203 Nigels Dr
Myrtle Beach, SC 29572-4177

Mailing address

8203 Nigels Dr
Myrtle Beach, SC 29572-4177
Phone (843) 491-1630

Other practice location 1

1920 2nd Loop Rd
Florence, SC 29501-6123
Phone (864) 626-5991

Other practice location 2

4600 Oleander Dr Ste 1
Myrtle Beach, SC 29577
Phone (843) 497-5323

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
I20170726004292 SC Practitioner - Nurse Practitioner 9032489893 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20864SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Physician Group LLC CurrentSince Sep 5, 2019 Accepting new patients
Oaktree Medical Centre, PC Past Accepting new patients

Locations

13 Corporate Blvd NE
Ste 100
Brookhaven, GA 30329
Phone (229) 442-7210

3970 Five Forks Trickum Rd SW
#A
Lilburn, GA 30047
Phone (678) 880-4836

7201 Brookfield Rd
Columbia, SC 29223
Phone (678) 505-9657

8203 Nigels Dr
Myrtle Beach, SC 29572
Phone (843) 251-0818

8203 Nigels Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-5848

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1952833279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8203 NIGELS DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724177",
            "telephone_number": "843-491-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8203 NIGELS DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724177",
            "telephone_number": "843-491-1630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1920 2nd Loop Rd",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295016123",
            "country_code": "US",
            "telephone_number": "864-626-5991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4600 Oleander Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "29577",
            "country_code": "US",
            "telephone_number": "843-497-5323",
            "fax_number": "843-497-5314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "JAMMIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.