Individual provider Active NPI

Carol Meltzer Beckenhauer, FNP

  • Family Nurse Practitioner
  • Seneca, SC
National Provider Identifier
1013085851
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2726 Issued in SC
Practice address
12016 N Radio Station Rd
Seneca, SC 29678-1143
Phone
(864) 882-6141
Fax
(864) 882-6680
NPI assigned
Dec 1, 2006
Last updated
Sep 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2726 SC Primary

Addresses

Primary practice location

12016 N Radio Station Rd
Seneca, SC 29678-1143

Mailing address

1 Independence PT
Suite 212
Greenville, SC 29615-4545
Phone (864) 797-6044

Other identifiers 1

IdentifierTypeStateIssuer
GP4697MedicaidSC

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
I20070124000020 SC Practitioner - Nurse Practitioner 3173524873 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2726SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rosa Clark Medical Clinic Association, Inc. CurrentSince Oct 1, 2020 Accepting new patients
Rosa Clark Medical Center CurrentSince Oct 1, 2020 Accepting new patients
Cape Coral Emergency Physicians Past Accepting new patients
All X Ray Diagnostic Services Corp Past Accepting new patients

Locations

301 Memorial Dr
Seneca, SC 29672
Phone (864) 614-5617

Organizations & group practices 4

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1013085851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6044",
            "fax_number": "864-797-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12016 N RADIO STATION RD",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296781143",
            "telephone_number": "864-882-6141",
            "fax_number": "864-882-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKENHAUER",
        "first_name": "CAROL",
        "middle_name": "MELTZER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "2726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4697",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.