Jacquelyn B Waldron (NPI# 1982647525, PAC ID# 3274538467) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1982647525 |
| PAC ID by PECOS | 3274538467 |
| Professional Enrollment ID | I20060921000345 |
| Full Name | Jacquelyn B Waldron |
| Organization Legal Name | SELF MEDICAL GROUP |
| Address |
22580 Hwy 76 E 100 Laurens SC 29360 |
| Phone Number | 8648335986 |
| Gender | F |
| Credential | NP |
| Graduation Year | 1996 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6002953916 |
| Number of Group Practice Members | 274 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420071 | SELF REGIONAL HEALTHCARE |
| 420038 | GHS LAURENS COUNTY MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 22580 Hwy 76 E 100, Laurens, SC 29360 | 8648335986 | SELF MEDICAL GROUP |
| Organization Legal Name | SELF MEDICAL GROUP |
| Physicians | 246 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mariah Montana Aden | Physician Assistant | Self Medical Group | 2605 Kinard St, Suite 200, Newberry, SC 29108-2965 |
| Myria Petrou | Diagnostic Radiology | Self Medical Group | 180 Broad St, Apt 1332, Stamford, CT 06901-5000 |
| Sylvia Gyapong | Diagnostic Radiology | Self Medical Group | 11035 Longboat Key Ln, Apt 308, Tampa, FL 33626-2754 |
| Anas Abdel Azim | Vascular Surgery | Self Medical Group | 160 Academy Ave, Greenwood, SC 29646-3808 |
| Varinder Kaur Singh | Family Medicine | Self Medical Group | 207 Holiday Rd, Mc Cormick, SC 29835-3430 |
| Jill Bell Shirley | Nurse Practitioner | Self Medical Group | 105 Vinecrest Ct, Suite 1000, Greenwood, SC 29646-8031 |
| Brian W Gunter | Infectious Disease | Self Medical Group | 104 Liner Dr, Greenwood, SC 29646-2310 |
| John Vincent Maylock | Family Medicine | Self Medical Group | 1228 Hwy 72 W, Greenwood, SC 29649-1816 |
| Kristal Smith Pitts | Nurse Practitioner | Self Medical Group | 421 Epting Ave, Greenwood, SC 29646-4041 |
| Leanna Willis Owings | Nurse Practitioner | Self Medical Group | 102 R L Sawyer Md Dr, Saluda, SC 29138-9199 |
| Street Address |
22580 HWY 76 E 100 |
| City | LAURENS |
| State | SC |
| Zip | 29360 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cathy P Pasco | Nurse Practitioner | Self Medical Group | 22580 Hwy 76 E 200, Laurens, SC 29360 |
| Burgess M Mauldin | Family Medicine | Self Medical Group | 22580 Hwy 76 E 300, Laurens, SC 29360 |
| Georgia G Lesser | Family Medicine | Self Medical Group | 22580 Hwy 76 E 300, Laurens, SC 29360 |
| Angela A Thomas | Nurse Practitioner | Self Medical Group | 22580 Hwy 76 E 300, Laurens, SC 29360 |
| Quoc Anh Thoung Nguyen | Family Medicine | Self Medical Group | 22580 Hwy 76 E 300, Laurens, SC 29360 |
| Veronda Janelle Mciver | Nurse Practitioner | Self Medical Group | 22580 Hwy 76 E 300, Laurens, SC 29360 |
| Denise Walker Thompson | Nurse Practitioner | Self Medical Group | 22580 Hwy 76 E 300, Laurens, SC 29360 |
| Kristi Denise Ford-scales | Family Medicine | Self Medical Group | 22580 Hwy 76 E 300, Laurens, SC 29360 |
| Grayson T Sumner | Family Medicine | Self Medical Group | 22580 Hwy 76 E 300, Laurens, SC 29360 |
| Rene L Brown | Family Medicine | Self Medical Group | 22580 Hwy 76 E 300, Laurens, SC 29360 |
| Find all physicians in zip 29360 | |||
| City | LAURENS |
| Zip Code | 29360 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LAURENS + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Jacquelyn B Waldron.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.