JIMMY GREGORY STEVENS (NPI# 1487294179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487294179 |
| Entity Type | Individual |
| Full Name | JIMMY GREGORY STEVENS |
| Practice Address |
920 Doug White Dr Ste 130 Myrtle Beach SC 29572-4120 |
| Practice Telephone | 8438481440 |
| Practice Fax Number | 8438391654 |
| Mailing Telephone | 8438481440 |
| Mailing Fax Number | 8438391654 |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2020-03-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3455 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720488695 | Jimmy Stevens Jr. | Pharmacist | 10160 E Bell Rd, Scottsdale, AZ 85260-2340 | 2014-08-28 |
| 1710022603 | Jimmy Lee Stevens | Psychologist | 1517 Nicholasville Rd, 400, Lexington, KY 40503-1429 | 2007-02-20 |
| Street Address |
920 DOUG WHITE DR STE 130 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720063837 | Scott F Duncan V | Orthopaedic Surgery | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2005-12-12 |
| 1225686835 | Kaycee Lauren Villane | Physician Assistant | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2019-08-27 |
| 1144660986 | Jesse Marsh Putman | Orthopaedic Surgery | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2013-06-25 |
| 1730201112 | Christopher Garrett Boullion | Orthopaedic Surgery | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2007-04-04 |
| 1427127653 | Amanda C. Barber | Physician Assistant | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2006-11-06 |
| 1235195850 | Joseph K Bethle | Physician Assistant | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4180 | 2006-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684576 | Matthew David Zeuschner | Nurse Practitioner | 107 Woodwind Court, Myrtle Beach, SC 29572 | 2020-09-16 |
| 1578191789 | Julia Ruth Nelson | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-04-01 |
| 1407484835 | Justin Schevers | Student in an Organized Health Care Education/Training Program | 802 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-31 |
| 1922636919 | Darian Michael Quigg | Student in an Organized Health Care Education/Training Program | 809 82nd Street Parkway, Myrtle Beach, SC 29572 | 2020-03-27 |
| 1881221141 | Jonathan Alden Bryan | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-26 |
| 1215575238 | Polaris Skin Diagnostics, LLC | Dermatology | 8170 Rourk Street, Suite 100, Myrtle Beach, SC 29572 | 2019-12-20 |
| 1700348711 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 9547 N Kings Hwy, Myrtle Beach, SC 29572 | 2019-04-01 |
| 1154882975 | Michael Kouandjio | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center-gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-26 |
| 1154880102 | Dylan Chase Morgan | Internal Medicine | Grand Strand Medical Center - Gme Office, 809 82nd Pkwy, Myrtle Beach, SC 29572 | 2019-03-19 |
| 1710446828 | David Redding Kingery Jr. | Student in an Organized Health Care Education/Training Program | Gme Office 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-18 |
| Find all providers in zip 29572 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910596 | Sarah Xiao Jing Jarema | Physician Assistant | 1211 Hadley Cir Unit 4301, Myrtle Beach, SC 29577-8219 | 2020-10-24 |
| 1750553152 | Daniella Deperi | Physician Assistant | 5046 Highway 17 Byp S Ste 103, Myrtle Beach, SC 29588-4503 | 2008-03-26 |
| 1831204676 | Mercedes Zimmerman Davis | Physician Assistant | 106 Lansford Pl, Myrtle Beach, SC 29588-6979 | 2006-08-20 |
| 1033181193 | Tracy Reymore Black | Physician Assistant | 8208 Devon Court, Suite B, Myrtle Beach, SC 29572 | 2006-02-03 |
| 1619969250 | Randall Paul Grove | Physician Assistant | 1101 Johnson Ave, Myrtle Beach, SC 29577-1893 | 2005-08-19 |
| 1487655106 | Ashley Smith Wilson | Physician Assistant | 945 82nd Parkway, Myrtle Beach, SC 29572 | 2005-08-03 |
| 1225686835 | Kaycee Lauren Villane | Physician Assistant | 920 Doug White Dr Ste 130, Myrtle Beach, SC 29572-4120 | 2019-08-27 |
| 1477100766 | Sarah Snyder Brown | Physician Assistant | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2019-08-21 |
| 1619523412 | Strand Physician Specialists, Pa | Physician Assistant | 945 82nd Pkwy, Myrtle Beach, SC 29572-4612 | 2019-08-16 |
| 1700430345 | Korreda Gause | Physician Assistant | 8120 Rourk St, Myrtle Beach, SC 29572-4127 | 2019-07-31 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
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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.