Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

JACK WAYNE TAKERIAN
NPI 1215833496
Physician Assistant in Charleston, SC

Q: What is Jack Takerian's NPI number?

The NPI number for Jack Takerian is 1215833496. It was assigned to this individual provider in the NPPES registry on October 15, 2026.

Q: What is Jack Takerian's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Takerian was last updated on October 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 15, 2026

1605 EVERGREEN ST, CHARLESTON, SC 29407(414) 419-5850 Get Directions Write a Review

NPPES record added: October 15, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Jack Wayne Takerian NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK WAYNE TAKERIAN (NPI 1215833496) is an individual physician assistant in Charleston, South Carolina and active in the NPI registry since October 2026.

NPPES Registry Identity

NPI1215833496

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJACK WAYNE TAKERIAN

Location Address1605 EVERGREEN STCharleston, SC 29407-6262

Mailing Address1605 Evergreen StCharleston, SC 29407-6262 · (414) 419-5850

Phone(414) 419-5850

Sole ProprietorYes

Enumeration DateOctober 15, 2026

NPPES CertifiedOctober 15, 2026

✔ NPI 1215833496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1605 EVERGREEN ST, Charleston, SC 29407

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Takerian's NPI number?

The NPI number for Jack Takerian is 1215833496. It was assigned to this individual provider in the NPPES registry on October 15, 2026.

Where is Jack Takerian located?

Jack Takerian practices at 1605 Evergreen St, Charleston, SC 29407. The listed phone number is (414) 419-5850.

What is Jack Takerian's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Jack Takerian was last updated on October 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.