Individual provider Active NPI

Cami Lynn Niskanen, NP STUDENT

  • Family Nurse Practitioner
  • Greer, SC
National Provider Identifier
1053058917
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27743 Issued in SC
Practice address
2225 River Rd
Greer, SC 29650-4507
Phone
(864) 423-0686
NPI assigned
May 12, 2022
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 27743 SC Primary
Registered Nurse 163W00000X 215692 SC

Addresses

Primary practice location

2225 River Rd
Greer, SC 29650-4507

Mailing address

2225 River Rd
Greer, SC 29650-4507

Other practice location 1

135 Commonwealth Dr Ste 100
Greenville, SC 29615-6940
Phone (864) 365-0200

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
I20240705000061 SC Practitioner - Nurse Practitioner 6608310347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Francis Physician Services IncGroup PAC ID 6608826821, 106 clinicians

Practice addresses (Care Compare)

1200 Brookfield Blvd
Suite 400B
Greenville, SC 29607-6583
Phone (864) 605-3721

305 Tanner Rd
Greenville, SC 29607-5923
Phone (864) 627-1220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
215692SCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Services Inc CurrentSince Jul 1, 2024 Accepting new patients
St Francis Physician Services Inc Past Accepting new patients
St. Francis Physician Services Inc Past Accepting new patients

Locations

1200 Brookfield Blvd
Ste 400B
Greenville, SC 29607
Phone (864) 605-3721

135 Commonwealth Dr
Ste 100
Greenville, SC 29615
Phone (864) 365-0200

305 Tanner Rd
Greenville, SC 29607
Phone (864) 627-1220

307 Tanner Rd
Greenville, SC 29607
Phone (864) 286-9050

Interoperability endpoints

  • Direct secure messaging: cniskanen1277505@direct.bsmhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1053058917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 RIVER RD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296504507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 RIVER RD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296504507",
            "telephone_number": "864-423-0686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 Commonwealth Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296156940",
            "country_code": "US",
            "telephone_number": "864-365-0200",
            "fax_number": "877-893-3772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NISKANEN",
        "first_name": "CAMI",
        "middle_name": "LYNN",
        "credential": "NP STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "27743",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "215692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.