NPIMap

Individual provider Active NPI

Stephanie Eyvette Averette, NP

  • Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1124113170
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
891 Issued in SC
Practice address
8301 Farrow Rd
Columbia, SC 29203-3245
Phone
(803) 935-7879
Fax
(803) 935-5280
NPI assigned
Oct 4, 2006
Last updated
Aug 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 891 SC Primary

Addresses

Primary practice location

8301 Farrow Rd
Columbia, SC 29203-3245

Mailing address

220 Faison Dr
Columbia, SC 29203-3210
Phone (803) 935-7140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090105000508 SC Practitioner - Nurse Practitioner 2466489604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Howard University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

220 Faison Dr
Columbia, SC 29203-3210
Phone (803) 898-8415

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
891SCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients

Locations

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1124113170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 FAISON DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292033210",
            "telephone_number": "803-935-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 FARROW RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292033245",
            "telephone_number": "803-935-7879",
            "fax_number": "803-935-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERETTE",
        "first_name": "STEPHANIE",
        "middle_name": "EYVETTE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.