| Jessica C Blake, FNP | |
|
7430 College St, Irmo, SC 29063-2903 | |
| (839) 200-7810 | |
| (803) 891-7085 |
| Full Name | Jessica C Blake |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 3 Years |
| Location | 7430 College St, Irmo, South Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760154447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 25430 (South Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 25430 (South Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Prisma Health Baptist Parkridge | Columbia, SC | Hospital |
| Prisma Health Baptist | Columbia, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Three Rivers Medical Associates Pa | 1557267663 | 14 |
| Medcare Express - North Charleston Llc | 7618074899 | 62 |
| Entity Name | Mcleod Regional Medical Center Of The Pee Dee, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154371433 PECOS PAC ID: 7416851852 Enrollment ID: O20031126000251 |
| Entity Name | Three Rivers Medical Associates Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760445597 PECOS PAC ID: 1557267663 Enrollment ID: O20031210000142 |
| Entity Name | Medcare Express - North Charleston Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457579617 PECOS PAC ID: 7618074899 Enrollment ID: O20070523000200 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica C Blake, FNP 7430 College St, Irmo, SC 29063-2903 Ph: (839) 200-7810 | Jessica C Blake, FNP 7430 College St, Irmo, SC 29063-2903 Ph: (839) 200-7810 |
Amanda Dudley, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Wellness Blvd Ste 109, Irmo, SC 29063 Phone: 803-749-1111 Fax: 803-749-0050 | |
Alicia Pendergrass, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Wellness Blvd Ste 203, Irmo, SC 29063 Phone: 803-749-9920 Fax: 803-749-9916 | |
Erin Faulkenberry Siciliano, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7182 Woodrow St Ste 200, Irmo, SC 29063 Phone: 803-749-1111 Fax: 803-749-0050 | |
Ms. Louise C. Holmes, MN,RN, CANP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7430 College St, Irmo, SC 29063 Phone: 803-732-4001 Fax: 803-732-2123 | |
Mrs. Stefanie Lee Gunn, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7182 Woodrow St Ste 200, Irmo, SC 29063 Phone: 803-749-1111 Fax: 803-749-0050 | |
Mrs. Rachel Strange, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7182 Woodrow St Ste 200, Irmo, SC 29063 Phone: 803-749-1111 Fax: 803-749-0050 | |
Janeen Jensen Wood, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1008 Lake Murray Blvd, Irmo, SC 29063 Phone: 803-749-3840 |