| Jordan Ashley Grice, APRN | |
|
200 College St, Spartanburg, SC 29303-3556 | |
| (864) 582-2411 | |
| (864) 594-0040 |
| Full Name | Jordan Ashley Grice |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 200 College St, Spartanburg, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003667221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 28474 (South Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 28474 (South Carolina) | Primary |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194710426 PECOS PAC ID: 8022928001 Enrollment ID: O20050127000120 |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548528714 PECOS PAC ID: 8022928001 Enrollment ID: O20160816002916 |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457745952 PECOS PAC ID: 8022928001 Enrollment ID: O20170127000968 |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982248852 PECOS PAC ID: 8022928001 Enrollment ID: O20210120001241 |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558946376 PECOS PAC ID: 8022928001 Enrollment ID: O20220630000562 |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Ashley Grice, APRN Po Box 5158, Spartanburg, SC 29304-5158 Ph: (864) 582-2411 | Jordan Ashley Grice, APRN 200 College St, Spartanburg, SC 29303-3556 Ph: (864) 582-2411 |