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

Jordan Bennett Wicker, PA

Individual provider Physician Assistant · NPI 1366979213

Jordan Bennett Wicker, PA is a Physician Assistant in Florence, South Carolina. Qualified in 2017, 9 years ago. Practices with Carolina Radiology Associates LLC, a 63-clinician group and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2017
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

555 E Cheves St
Florence, SC 29506-2617
Phone: (843) 777-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1366979213
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 22, 2017
Last updated in NPPESAugust 2, 2024
Certification dateAugust 2, 2024
Mailing address555 E. Cheves St., Attn: Radiology Department, Florence, SC 29506-2617

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Carolina Radiology Associates Llc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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