Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jennifer Desiree Douglas, PA

Individual provider Physician Assistant · NPI 1023044906

Jennifer Desiree Douglas, PA is a Physician Assistant in Charleston, South Carolina. Qualified in 2000, 26 years ago. Practices with University Medical Associates of the Medical University of South Carol, a 1,640-clinician group and accepts Medicare assignment. Licensed in Pennsylvania, South Carolina and Virginia.

Years since qualifying
26
Licensed in
PA, SC, VA
In the registry since
2006
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

171 Ashley Ave
Charleston, SC 29425-8908
Phone: (843) 792-1414
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 3509 (SC)
Physician Assistant Taxonomy 363A00000X · Licence MA051653 (PA)
Physician Assistant Taxonomy 363A00000X · Licence 0110001232 (VA)

Record details

NPI number1023044906
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 23, 2006
Last updated in NPPESApril 14, 2020
Certification dateApril 14, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice University Medical Associates Of The Medical University Of South Carol — 1640 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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