Individual provider Active NPI

Lisa Sherman Haselden, PA-C

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1003867789
Registry record updated Aug 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1105 Issued in SC
Practice address
950 W Faris Rd
Greenville, SC 29605-4255
Phone
(864) 271-3444
Fax
(864) 255-7877
NPI assigned
May 15, 2006
Last updated
Aug 19, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1105 SC Primary

Addresses

Primary practice location

950 W Faris Rd
Greenville, SC 29605-4255

Mailing address

950 W Faris Rd
Greenville, SC 29605-4255
Phone (864) 271-3444

Other names 1

  • Lisa Marie Sherman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060712000338 SC Practitioner - Physician Assistant 1658384763 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1105SCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Health System CurrentSince Mar 27, 2006 Accepting new patients
Shriners Hospitals for Children Physician Assistant CurrentSince Mar 22, 2014 Accepting new patients
Shriners Hospitals for Children CurrentSince Mar 22, 2014 Accepting new patients
Doctors Care, PA Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients
Greenville Health System Past Accepting new patients

Locations

950 W Faris Rd
Greenville, SC 29605
Phone (864) 255-7941

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250640000000",
    "number": "1003867789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054255",
            "telephone_number": "864-271-3444",
            "fax_number": "864-255-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054255",
            "telephone_number": "864-271-3444",
            "fax_number": "864-255-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASELDEN",
        "first_name": "LISA",
        "middle_name": "SHERMAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2009-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SHERMAN",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.