Individual provider Active NPI

Laura E Herbert, N.P.

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1043661986
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20279 Issued in SC
Practice address
115 Blarney Dr
Suite 108
Columbia, SC 29223-6291
Phone
(803) 462-9200
Fax
(803) 699-1474
NPI assigned
Jun 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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 20279 SC Primary

Addresses

Primary practice location

115 Blarney Dr
Suite 108
Columbia, SC 29223-6291

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other identifiers 1

IdentifierTypeStateIssuer
NP4006MedicaidSC

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
I20160902000233 SC Practitioner - Nurse Practitioner 4486940251 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20279SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Primary Care Physicians, LLC CurrentSince Apr 21, 2022 Accepting new patients
Palmetto Primary Care Physicians, LLC Current Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Nov 26, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Nov 26, 2016 Accepting new patients
Palmetto Primary Care Physicians, LLC CurrentSince Apr 21, 2022 Accepting new patients

Locations

1401 Main St
Bonneau, SC 29431
Phone (843) 825-3404

710 Rabon Rd
Ste 203
Columbia, SC 29203
Phone (803) 274-6166

3555 Harden Street Ext
Columbia, SC 29203
Phone (803) 434-6410

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

2550 Elms Center Rd
North Charleston, SC 29406
Phone (843) 302-8840

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1043661986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BLARNEY DR",
            "address_2": "SUITE 108",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236291",
            "telephone_number": "803-462-9200",
            "fax_number": "803-699-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBERT",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4006",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.