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DR. JIMMY LEE GOWAN M.D.
NPI 1366830648
General Practice in Moore, SC

Active since January 08, 2015Opted out of Medicare · through Dec 28, 2027
513 S SWEETWATER HILLS DR, MOORE, SC 29369(864) 486-8379 Get Directions Write a Review

NPPES record last updated: January 8, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jimmy Lee Gowan M.d. NPPES

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

DR. JIMMY LEE GOWAN M.D. (NPI 1366830648) is an individual general practice provider in Moore, South Carolina, licensed in South Carolina (SC 4935) and active in the NPI registry since January 2015. He has opted out of Medicare through December 28, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1366830648
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. JIMMY LEE GOWANCredential: M.D.
Location Address513 S SWEETWATER HILLS DRMoore, SC 29369-9550
Mailing Address513 S Sweetwater Hills DrMoore, SC 29369-9550 · (864) 486-8379
Phone(864) 486-8379
Sole ProprietorYes
Enumeration DateJanuary 8, 2015
✔ NPI 1366830648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in SC · SC 4935
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
513 S SWEETWATER HILLS DR, Moore, SC 29369
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jimmy Lee Gowan M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 28, 2015 through December 28, 2027.

Opt-Out Effective DateDecember 28, 2015
Opt-Out In Effect ThroughDecember 28, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Jimmy Gowan's NPI number?

The NPI number for Jimmy Gowan is 1366830648. It was assigned to this individual provider in the NPPES registry on January 8, 2015.

Where is Jimmy Gowan located?

Jimmy Gowan practices at 513 S Sweetwater Hills Dr, Moore, SC 29369. The listed phone number is (864) 486-8379.

What is Jimmy Gowan's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Jimmy Gowan enrolled in Medicare?

No. Jimmy Gowan has opted out of Medicare through December 28, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jimmy Gowan was last updated on January 8, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.