Active NPI
Robert Charles Daniel Aten, PA
- Physician Assistant
- Greenville, SC
National Provider Identifier
1053894873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3349
- Practice address
- 701 Grove Rd FL 1
Greenville, SC 29605-4210 - Phone
- (864) 455-7899
- Fax
- (864) 455-5474
- NPI assigned
- Sep 7, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3349 | SC | Primary |
| Physician Assistant | 363A00000X | 0010-08522 | NC |
Addresses
Primary practice location
701 Grove Rd FL 1
Greenville, SC 29605-4210
Mailing address
1 Independence PT Ste 212
Greenville, SC 29615-4536
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-08522 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southland Consolidated Emergency Services, LLC | Current | Accepting new patients | |
| Southland Evans Emergency Medical Services LLC | Past | Accepting new patients |
Locations
1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100
4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527
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 and National Provider Directory roles.
-
- Emergency Medicine Physician
- Elberton, GA
- NPI 1174917124
-
- Hospitalist Physician
- Bainbridge, GA
- NPI 1356735336
-
- Emergency Medicine Physician
- Claxton, GA
- NPI 1730697418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1053894873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 INDEPENDENCE PT STE 212",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 GROVE RD FL 1",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054210",
"telephone_number": "864-455-7899",
"fax_number": "864-455-5474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATEN",
"first_name": "ROBERT",
"middle_name": "CHARLES DANIEL",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-07",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SC",
"license": "3349",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-08522",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.