JACQUELYN SUZETTE AMMONS


Address: 9330 Medical Plaza Dr, Charleston, SC 29406-9104
Phone: 8438474876

JACQUELYN SUZETTE AMMONS (NPI# 1669965810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1669965810
Entity Type Individual
Full Name JACQUELYN SUZETTE AMMONS
Credential ACNP
Practice Address 9330 Medical Plaza Dr
Charleston
SC 29406-9104
Mailing Address 9330 Medical Plaza Dr
North Charleston
SC 29406-9104
Practice Telephone 8438474876
Mailing Telephone 8438474882
Enumeration Date 2018-06-12
Last Update Date 2018-10-01
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2100X Nurse Practitioner
Specialization: Acute Care
21768 SC Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
ICC HEALTHCARE LLC 1720210586 01

Office Location

Street Address 9330 MEDICAL PLAZA DR
City CHARLESTON
State SC
Zip Code 29406-9104

Providers in the same location

NPI Name Taxonomy Address Enumeration
1285632638 Thomas A Privett Psychiatry & Neurology 9330 Medical Plaza Dr, Charleston, SC 29406 2005-07-11
1740896380 Robert Palmer Wolfrom Nurse Anesthetist, Certified Registered 9330 Medical Plaza Dr, Charleston, SC 29406-9104 2020-09-18
1801415872 Holly Robinson Nurse Anesthetist, Certified Registered 9330 Medical Plaza Dr, Charleston, SC 29406-9104 2020-04-10
1578192951 Destine Hoover Pharmacist 9330 Medical Plaza Dr, Charleston, SC 29406-9104 2020-04-07
1134751829 Julie Ivester Hayler Nurse Practitioner 9330 Medical Plaza Dr, Charleston, SC 29406-9104 2020-02-10
1659903078 Elizabeth Mary Chouinard Registered Nurse 9330 Medical Plaza Dr, Charleston, SC 29406-9104 2020-02-05
1174018162 Priscilla Hurt Social Worker 9330 Medical Plaza Dr, Charleston, SC 29406-9104 2018-06-22
1396249819 Jennifer L Allmon Nurse Anesthetist, Certified Registered 9330 Medical Plaza Dr, Charleston, SC 29406 2018-03-20
1609395458 Mason Patrick Weisgarber Physician Assistant 9330 Medical Plaza Dr, Charleston, SC 29406-9104 2017-09-13
1437676707 Avery Shawen Pharmacist 9330 Medical Plaza Dr, Charleston, SC 29406-9104 2017-08-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1023622289 Sara Desmarais Physical Therapist 2760 Tricom St, North Charleston, SC 29406 2020-09-04
1669036448 Pink Elephant Autism Project In Home Supportive Care 8738 Red Oak Drive, Charleston, SC 29406 2019-04-26
1083171185 Medical University Hospital Authority Pharmacy 2250 Mall Drive, North Charleston, SC 29406 2019-02-25
1336627371 Truesdale Medical Center LLC Internal Medicine 6296 Rivers Ave., Suite 310, N. Charleston, SC 29406 2018-08-01
1164914552 Amanda R Dipiazza Nurse Anesthetist, Certified Registered 9330 Medical Plaza Dr Ste E, Charleston, SC 29406 2018-06-01
1982148490 Trident Medical Center Psychiatric Hospital 9225 C Medical Plaza Drive, Charleston, SC 29406 2016-12-19
1649726217 First Choice Counseling Services, LLC Community/Behavioral Health 2245 Greenridge Rd., Unit#414, North Charleston, SC 29406 2016-09-01
1821443896 Liberty Doctors, LLC Family Medicine 9275 D Medical Plaza Dr., North Charleston, SC 29406 2016-04-27
1174984645 Ashia George Developmental Therapist 6650 Rivers Avenue, Ste 100, Charleston, SC 29406 2016-03-11
1023488582 Etta Smith Counselor 2470 Mall Dr Unit Cd, North Charleston, SC 29406 2015-09-28
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Taxonomy Information

Taxonomy Code 363LA2100X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Acute Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881174936 Jaclyn Sudol Nurse Practitioner 2946 Ashley River Rd, Charleston, SC 29414-7049 2018-08-17
1427437821 Wv Phs LLC Nurse Practitioner 400 Patterson Ln, Charleston, WV 25311-1570 2015-05-19
1417933193 Emmie Elizabeth Steadman Nurse Practitioner 96 Jonathan Lucas St, Suite 424, Charleston, SC 29425-8900 2005-12-15
1285231340 Bree Romecki Nurse Practitioner 171 Ashley Ave, Charleston, SC 29425-0100 2020-10-02
1558971390 Auryelle Ascue Nurse Practitioner 171 Ashley Ave, Charleston, SC 29425-8908 2020-08-06
1356973820 Jason Foster Nurse Practitioner 1137 Sam Rittenberg Blvd, Charleston, SC 29407-3360 2020-02-12
1841830940 Daniel Christopher Michalski Nurse Practitioner 171 Ashley Ave, Charleston, SC 29425-5098 2020-01-07
1932747748 Chelsey A D Massey Nurse Practitioner 316 Calhoun St, Charleston, SC 29401-1113 2019-12-12
1417593526 Caitlin Marie Baker Nurse Practitioner 171 Ashley Ave, Charleston, SC 29425-8908 2019-11-24
1053957696 Lynn Jarrett Nurse Practitioner 3200 Maccorkle Ave Se, Charleston, WV 25304-1227 2019-11-19
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Competitor

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City CHARLESTON
Zip Code 29406

Improve Information

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Dataset Information

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.

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