JACKIE EMMANUEL QUEEN MD
NPI 1710417753
Internal Medicine in Greenville, SC

Q: What is the provider's specialty?

The provider's specialty is Internal Medicine with taxonomy code 207R00000X.

Active since June 13, 2017PECOS Enrolled

701 GROVE RD, GREENVILLE, SC 29605(864) 455-7844(864) 455-7848 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Sep 18, 2017, Jun 13, 2017 (3 updates tracked since 2017).

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About Jackie Emmanuel Queen Md NPPES

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

JACKIE EMMANUEL QUEEN MD (NPI 1710417753) is an individual internal medicine provider in Greenville, South Carolina, licensed in South Carolina (51169) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710417753

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameJACKIE EMMANUEL QUEENCredential: MD

Location Address701 GROVE RDGreenville, SC 29605-4210

Mailing Address1 Independence Pt Ste 212Greenville, SC 29615-4536 · (864) 797-6306

Phone(864) 455-7844

Fax(864) 455-7848

Sole ProprietorNo

Enumeration DateJune 13, 2017

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

✔ NPI 1710417753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in SC · 51169

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedPediatricsTaxonomy 208000000X · License 51169 (SC)

701 GROVE RD, Greenville, SC 29605

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackie Emmanuel Queen Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29605 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.