Angie Lynn Jacobs, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

46446 Issued in SC

Practice address

Crossroads Treatment Centers
209 Oconee Square Dr
Seneca, SC 29678

Phone

(800) 805-6989

NPI assigned

Oct 20, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Angie Lynn Whisnant Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1972385292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 CHEROKEE CIR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296255514",
            "telephone_number": "864-209-7758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CROSSROADS TREATMENT CENTERS",
            "address_2": "209 OCONEE SQUARE DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "29678",
            "telephone_number": "800-805-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "ANGIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SC",
            "license": "46446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGIE",
            "last_name": "WHISNANT",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Licensed Practical Nurse in Seneca, SC
• Providers in Seneca, SC by specialty
• Licensed Practical Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.