Surbhi Jain, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2019-02812 Issued in NC

Practice address

704 Gold Hill Rd
Suite 115
Fort Mill, SC 29715-8906

Phone

(803) 802-5181

NPI assigned

Jun 13, 2016

Sex

Female

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, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1982054730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 GOLD HILL RD",
            "address_2": "SUITE 115",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297158906",
            "telephone_number": "803-802-5181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15110 John J Delaney Dr",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773544",
            "country_code": "US",
            "telephone_number": "704-302-8100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_2": "Ste 420",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-302-8700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 S College St",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282022012",
            "country_code": "US",
            "telephone_number": "704-302-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "332 N Trade St",
            "address_2": "Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281051728",
            "country_code": "US",
            "telephone_number": "704-302-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIN",
        "first_name": "SURBHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "83573",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2019-02812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angenique Gloriann Jackson, D.C.
• Joan Marie Jackson, FNP
• Charles Russell Jaco, RPH
• Jessica Ann Jacobson, M.ED., LPC
• Sunny Jain
• Tammy Lynn James, LCSW, LISW
• Chelsea Clark Janasek, PT, DPT, OCS
• Jane E. Liotta, LPC, LLC
• Sydney Anne Jarrell
• Elizabeth A Jarrett, ATC

• Internal Medicine Physician in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.