Individual provider Active NPI

Sabrina Noelle Archibald, DO

  • Pediatrics Physician
  • Greer, SC
National Provider Identifier
1053992172
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DO83625 Issued in SC
Practice address
145 E Poinsett St
Greer, SC 29651-3405
Phone
(864) 272-0388
NPI assigned
Apr 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X DO83625 SC Primary

Addresses

Primary practice location

145 E Poinsett St
Greer, SC 29651-3405

Mailing address

PO Box 936934
Atlanta, GA 31193-6934

Other names 1

  • Sabrina Noelle Gerlich Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910000899 SC Practitioner - Pediatric Medicine 5496151987 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO83625SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Affiliate Physicians CurrentSince Sep 1, 2024 Accepting new patients
Musc Affiliate Physicians Pediatrics CurrentSince Sep 1, 2024 Accepting new patients
University Medical Associates Past Accepting new patients

Locations

9 Hawthorne Park Ct
Greenville, SC 29615
Phone (864) 286-1040

145 E Poinsett St
Greer, SC 29651
Phone 86460356003222

2 Hatcher Creek St
Simpsonville, SC 29680

Interoperability endpoints

  • Direct secure messaging: sarchibald355058@direct.musc.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1053992172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936934",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E POINSETT ST",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296513405",
            "telephone_number": "864-272-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIBALD",
        "first_name": "SABRINA",
        "middle_name": "NOELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "DO83625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "145 E Poinsett St",
            "city": "Greer",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296513405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SABRINA",
            "last_name": "GERLICH",
            "middle_name": "NOELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.