JESSIE C SANTIAGO JR. (NPI# 1003890591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003890591 |
| Entity Type | Individual |
| Full Name | JESSIE C SANTIAGO JR. |
| Credential | PA C |
| Practice Address |
1 Pinckney Blvd Attn Professional Affairs Coordinator Beaufort SC 29902-6148 |
| Mailing Address |
Po Box 6216a 1 Pinckney Blvd Attn Professional Affairs Coordinator Beaufort SC 29902-6148 |
| Practice Telephone | 8432285577 |
| Practice Fax Number | 8432285196 |
| Mailing Telephone | 8432285577 |
| Mailing Fax Number | 8432285196 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1041578 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1 PINCKNEY BLVD ATTN PROFESSIONAL AFFAIRS COORDINATOR |
| City | BEAUFORT |
| State | SC |
| Zip Code | 29902-6148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457352643 | Terry Lynn Elliott | Family Medicine | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2005-08-10 |
| 1366042327 | Selena Damiano | Physician Assistant | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2020-10-29 |
| 1023620150 | Duy Thien Vinh Truong | Dentist | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2020-08-19 |
| 1366060071 | Christopher Taylor Davis | Dentist | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2020-07-09 |
| 1942828884 | Abraham Kim | Dentist | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2020-07-07 |
| 1205468907 | Maurice Jones | Nurse Practitioner | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2020-02-10 |
| 1629610134 | Alicia Lynn Weaver | Dietitian, Registered | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2019-10-16 |
| 1710529995 | Jules C Martowski | Psychologist | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2019-10-09 |
| 1053968784 | John Claiborne Millar | Dentist | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2019-08-19 |
| 1043866049 | Celeste Roberts | Dentist | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2019-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063024578 | Beaufort County Memorial Hospital | Family Medicine | Beaufort Memorial Preoperative Assessment Clinic, 989 Ribaut Road Suite 370, Beaufort, SC 29902 | 2020-08-18 |
| 1750992475 | Fayth Polite | Social Worker | 2210 Salem Drive East, Beaufort, SC 29902 | 2020-08-14 |
| 1417509530 | Andrew Grant Miner | Dentist | Naval Hospital Beaufort, 1 Pinckney Blvd., Fpo, AA 29902 | 2019-07-09 |
| 1376029777 | Edward Dela Fuente | Counselor | Coastal Empire Mental Health Center, 1050 Ribaut Road, Beaufort, SC 29902 | 2018-07-18 |
| 1114440419 | Kristin Webb | Registered Nurse | 607 Wilmington Street, Beaufort, SC 29902 | 2017-07-19 |
| 1326582081 | Annemarie Gierling Gault | Nurse Practitioner | Beaufort Memorial Medical Oncology Infusion Center, 989 Ribaut Rd, Ste 103, Beaufort, SC 29902 | 2016-12-14 |
| 1114396579 | Jacquelyn Faith Proulx | Dentist | 1 Pickney Blvd., Naval Hospital Beaufort, Beaufort, SC 29902 | 2015-09-16 |
| 1386028413 | Howard Family Dental - Beaufort, Pllc | Dentist | 35 Robert Smalls Pkwy, Beaufort, SC 29902 | 2015-07-18 |
| 1598018103 | Lisa Marie Johnson | Occupational Therapist | 9555 Ribaut Road, Beaufort Memorial Hospital, Beaufort, SC 29902 | 2012-10-19 |
| 1134497860 | Jeremy Michael Simmons | Pharmacist | 2127 Boundary Street, Suite 19, Beaufort, SC 29902 | 2011-12-08 |
| Find all providers in zip 29902 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265612147 | Suzanne Jane Dirienzo | Physician Assistant | 1pinckney Blvd., Naval Hospital At Beaufort, Beaufort, SC 29902 | 2007-11-08 |
| 1073600698 | Denise Mcallister Mercier | Physician Assistant | 989 Ribaut Rd Ste 340, Beaufort, SC 29902-5426 | 2006-10-06 |
| 1063491025 | Eric Dean Gearhart | Physician Assistant | 10a Marshellen Dr, Beaufort, SC 29902-6900 | 2006-01-10 |
| 1801269303 | Margaret Tanner Miler | Physician Assistant | Beaufort Memorial Lowcountry Medical Group, 300 Midtown Dr, Beaufort, SC 29906-5200 | 2015-11-05 |
| 1942699723 | Paul James Schaefer | Physician Assistant | 989 Ribaut Rd, Beaufort, SC 29902-5472 | 2015-01-15 |
| 1801197272 | Brittany Fernald Zip | Physician Assistant | 955 Ribaut Rd, Beaufort, SC 29902-5441 | 2010-11-16 |
| 1114253242 | David Orlando Caraballo | Physician Assistant | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2009-10-24 |
| 1356585525 | Kate Elizabeth D'orazio | Physician Assistant | 955 Ribaut Rd, Beaufort Memorial Hospital, Beaufort, SC 29902-5441 | 2009-05-01 |
| 1649390667 | Lisa C Kessler | Physician Assistant | 1 Pinckney Blvd, Beaufort, SC 29902-6122 | 2007-03-31 |
| 1942348859 | Linda Michelle Hubbard | Physician Assistant | 300 Midtown Dr, Spine Suite, Beaufort, SC 29906-5200 | 2007-02-02 |
| Find all providers in BEAUFORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.