Whitley Weatherford

Individual provider Active NPI Family Nurse Practitioner · Scranton, SC

NPI 1073073532 · NPPES record last updated Mar 21, 2019

Key facts

NPI
1073073532
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
22724 (SC)
Practice address
288 Anderson Bridge Rd
Scranton, SC 29591-5002
Phone
(843) 373-0554
NPI assigned
Mar 21, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 19

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Pruitthealth Hospice Inc (42 clinicians)

Practice addresses (Care Compare)

2051 Elijah Ludd Rd
Suite 1
Florence, SC 29501-3942
Phone (843) 662-8633

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200311001940 SC Practitioner - Nurse Practitioner 8123456829 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Hospice, Inc. Current Accepting new patients
Pruitthealth Hospice, Inc. Current
since Sep 20, 2024
Accepting new patients
Pruitthealth Hospice, Inc. Current
since Sep 20, 2024
Accepting new patients

Locations

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

2051 Elijah Ludd Rd
Ste 1
Florence, SC 29501
Phone (843) 573-8623

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22724 SC Yes

Addresses

Primary practice location

288 Anderson Bridge Rd
Scranton, SC 29591-5002

Mailing address

288 Anderson Bridge Rd
Scranton, SC 29591-5002
Phone (843) 373-0554

Other providers in Scranton, SC

All providers in Scranton, SC · Family Nurse Practitioner in South Carolina

Sources for this page

Verify at the official NPI Registry.