JACOB SOOTER (NPI# 1851946453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851946453 |
| Entity Type | Individual |
| Full Name | JACOB SOOTER |
| Practice Address |
158 Harvest Moon Rd Moncks Corner SC 29461-6457 |
| Practice Telephone | 3162084591 |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
158 HARVEST MOON RD |
| City | MONCKS CORNER |
| State | SC |
| Zip Code | 29461-6457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982267605 | Berkeley Citizens Inc | Early Intervention Provider Agency | P0 Drawer 429 1301 Old Hwy 52 South, Moncks Corner, SC 29461 | 2019-04-18 |
| 1376015222 | Anthony Johnson | Counselor | 306 Airport Drive, Moncks Corner, SC 29461 | 2018-12-17 |
| 1598243719 | Jana Matthews Chinners | Family Medicine | 2061 Us-52, Moncks Corner, SC 29461 | 2018-07-31 |
| 1285151225 | Nathan Andrew Bostrom | Occupational Therapist | 118 Carolina Avenue, Moncks Corner, SC 29461 | 2017-08-29 |
| 1942730528 | Martina Snider | Specialist | 393 Corner Square Plaza, Moncks Corner, SC 29461 | 2017-06-15 |
| 1104355502 | Mary Elizabeth Perdue | Counselor | 306 Airport Dr., Moncks Corner, SC 29461 | 2017-06-08 |
| 1619390481 | Berkeley Citizens, Inc. | Public Health or Welfare | 1301 Old Hwy. 52 South, Moncks Corner, SC 29461 | 2014-01-29 |
| 1326384082 | Amanda Trueworthy | Counselor | 3156 F South Live Oak Drive, Moncks Corner, SC 29461 | 2012-12-27 |
| 1790040202 | Melanie Mcendree | Community Health Worker | 105 Lobolly Dr., Moncks Corner, SC 29461 | 2012-07-10 |
| 1891093845 | Leslie Erin Blackmon Stelling | Pharmacist | 110 South Highway 52, Moncks Corner, SC 29461 | 2011-02-28 |
| Find all providers in zip 29461 | ||||
| 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 |
|---|---|---|---|---|
| 1598300840 | Debra Anne Mack | Physician Assistant | 2061 Highway 52, Moncks Corner, SC 29461-5017 | 2019-11-11 |
| 1346732526 | Christina F. Reynolds | Physician Assistant | 115 Executive Pkwy, Moncks Corner, SC 29461-3955 | 2018-06-04 |
| 1073064200 | Svetlana Stuck | Physician Assistant | 110 Executive Pkwy, Moncks Corner, SC 29461-3930 | 2016-10-24 |
| 1255733671 | Ashlyn Burns | Physician Assistant | 2061 Highway 52, Moncks Corner, SC 29461-5017 | 2014-09-17 |
| 1942535570 | Stefanie Lynn Cretella | Physician Assistant | 115 Executive Pkwy, Moncks Corner, SC 29461-3955 | 2009-10-15 |
| 1700935699 | Phillip William Tolman | Physician Assistant | 511 N Highway 52, Moncks Corner, SC 29461-3132 | 2007-01-09 |
| 1053349787 | Cindy L Fiacco | Physician Assistant | 115 Executive Pkwy, Moncks Corner, SC 29461 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770712 | Hannah Jenkins | Physician Assistant | 780 Windrow Dr, Sumter, SC 29150-5318 | 2020-11-04 |
| 1255931283 | Sterling Simmons Capotosti | Physician Assistant | 1813 Joseph Cir, Florence, SC 29501-6339 | 2020-10-28 |
| 1538768098 | Hristos Stamatopoulos | Physician Assistant | 149 Independent Ln, Walterboro, SC 29488-6218 | 2020-10-25 |
| 1053910596 | Sarah Xiao Jing Jarema | Physician Assistant | 1211 Hadley Cir Unit 4301, Myrtle Beach, SC 29577-8219 | 2020-10-24 |
| 1063011062 | Sara Chmielewski | Physician Assistant | 283 Blvd De France, Parris Island, SC 29905 | 2020-10-21 |
| 1487252367 | Hannah Beddingfield | Physician Assistant | 200 Drury Ln, Mauldin, SC 29662-2228 | 2020-10-13 |
| 1275131054 | Ethan Brody Clontz | Physician Assistant | 1953 Pinehurst Ave, Charleston, SC 29414-6483 | 2020-10-13 |
| 1790383719 | Kaytlin Blake Hollingsworth | Physician Assistant | 2774 Shadow Ln, North Charleston, SC 29406-9065 | 2020-10-12 |
| 1487261509 | Reilly Kilpatrick | Physician Assistant | 1518 Blaze Ln, Charleston, SC 29412-8652 | 2020-09-24 |
| 1144836461 | Michael Joseph Haven | Physician Assistant | 221 Bayfront Dr Unit 224, Mount Pleasant, SC 29464-1825 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
| City | MONCKS CORNER |
| Zip Code | 29461 |
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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.