Marta Pacheco
Individual provider Active NPI Acute Care Nurse Practitioner · Rock Hill, SC
NPI 1053076554 · NPPES record last updated Jan 15, 2024
Key facts
- NPI
- 1053076554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 0024189006 (VA)
- Practice address
- 1617 Shetland LN
Rock Hill, SC 29730-4998 - Phone
- (540) 797-4361
- NPI assigned
- Nov 1, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Friendship Physician Clinic Inc
Provider Partners Care Management LP
Practice addresses (Care Compare)
391 Hershberger Rd
Roanoke, VA 24012-1983
Phone (540) 265-2087
46531 Leesburg Pike
Sterling, VA 20164-3555
Phone (703) 834-5800
Hospital & facility affiliations
- Enhabit Home Health (Roanoke)
- Good Samaritan Hospice Inc
- Lewisgale Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220813000100 | NC | Practitioner - Nurse Practitioner | 8123401866 | Reassigns benefits to 1 organization |
| I20240424002337 | VA | Practitioner - Nurse Practitioner | 8123401866 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000319019 | NC | MD | Acute Care Nurse Practitioner |
| 0024189006 | VA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Horizon Internal Medicine PLLC | Current | Accepting new patients | |
| Provider Partners Care Management LP | Current |
Accepting new patients | |
| Friendship Physician Clinic Inc | Current |
Accepting new patients | |
| Horizon Internal Medicine PLLC | Current |
Accepting new patients | |
| NC Elder Care PLLC | Past |
Accepting new patients |
Locations
8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097
138 Dublin Square Rd
Ste B
Asheboro, NC 27203
Phone (336) 610-1300
1380 Eastchester Dr
Ste 105
High Point, NC 27265
Phone (336) 610-1300
5647 Starkey Rd
Roanoke, VA 24018
Phone (540) 265-8097
391 Hershberger Rd
Roanoke, VA 24012
Phone (540) 265-2087
3719 Knollridge Rd
Salem, VA 24153
Phone (540) 265-2087
46531 Leesburg Pike
Sterling, VA 20164
Phone (703) 834-5800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 2000319019 | NC | |
| Acute Care Nurse Practitioner | 363LA2100X | 0024189006 | VA | Yes |
Addresses
Primary practice location
1617 Shetland LN
Rock Hill, SC 29730-4998
Mailing address
1617 Shetland LN
Rock Hill, SC 29730-4998
Phone (540) 797-4361
Other providers in Rock Hill, SC
- Catlin Owens
- Jessica Oxendine
- Edwin Iyere Ozua
- P&D Entities of SC, Inc
- Amanda Yvonne Pabon
- Deanna Padilla
- Gina R Padula
- Monica Pagan
- Palmetto Autism Services
- Palmetto Cardiology of York County, LLC.
All providers in Rock Hill, SC · Acute Care Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.