Individual provider Active NPI

Patricia Siefferman, NP-C

  • Family Nurse Practitioner
  • Abbeville, SC
National Provider Identifier
1093709453
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17559 Issued in SC
Practice address
901 W Greenwood St
Suite 5
Abbeville, SC 29620-5717
Phone
(864) 366-9938
Fax
(864) 366-0818
NPI assigned
Aug 31, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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 27377 GA
Family Nurse Practitioner 363LF0000X 17559 SC Primary

Addresses

Primary practice location

901 W Greenwood St
Suite 5
Abbeville, SC 29620-5717

Mailing address

12192 Augusta Rd
12192 Augusta Road
Lavonia, GA 30553-1209
Phone (706) 356-1072

Other identifiers 1

IdentifierTypeStateIssuer
000733048IJKMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27377GAMDPediatrics Physician
027377GAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Family Medicine LLC CurrentSince May 1, 2024 Accepting new patients

Locations

892 Prince Ave
Athens, GA 30606
Phone (706) 227-2027

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1093709453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12192 AUGUSTA RD",
            "address_2": "12192 AUGUSTA ROAD",
            "city": "LAVONIA",
            "state": "GA",
            "postal_code": "305531209",
            "telephone_number": "706-356-1072",
            "fax_number": "706-356-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W GREENWOOD ST",
            "address_2": "SUITE 5",
            "city": "ABBEVILLE",
            "state": "SC",
            "postal_code": "296205717",
            "telephone_number": "864-366-9938",
            "fax_number": "864-366-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEFFERMAN",
        "first_name": "PATRICIA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "27377",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "17559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000733048IJK",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abbeville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.