Elizabeth Z Thelan, CPNP
Individual provider Active NPI Nurse Practitioner · Forest City, NC
NPI 1124214895 · NPPES record last updated Feb 5, 2024
Key facts
- NPI
- 1124214895
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 5018499 (NC)
- Practice address
- 374 Hudlow Rd
Forest City, NC 28043-9444 - Phone
- (828) 245-0095
- NPI assigned
- Sep 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SC, NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071227000609 | SC | Practitioner - Nurse Practitioner | 4981784212 | Reassigns benefits to 1 organization |
| I20231208003441 | NC | Practitioner - Nurse Practitioner | 4981784212 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3357 | SC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospice Care of South Carolina, LLC | Current |
Accepting new patients | |
| Agape Care North Carolina, LLC | Current |
Accepting new patients | |
| Agape Care North Carolina, LLC | Current |
Accepting new patients | |
| Hospice Care of South Carolina, LLC | Past | Accepting new patients |
Locations
374 Hudlow Rd
Forest City, NC 28043
Phone (828) 245-0095
372 Hudlow Rd
Forest City, NC 28043
Phone (828) 245-0095
374 Hudlow Rd
Ste B
Forest City, NC 28043
Phone (828) 245-0095
136 Stonemark Ln
Ste 100C
Columbia, SC 29210
Phone (888) 701-4661
136 Stonemark Ln
Ste 100
Columbia, SC 29210
Phone (803) 603-4821
187 N Church St
Ste 201
Spartanburg, SC 29306
Phone (864) 630-8469
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 3357 | SC | |
| Nurse Practitioner | 363L00000X | 5018499 | NC | Yes |
Addresses
Primary practice location
374 Hudlow Rd
Forest City, NC 28043-9444
Mailing address
2051 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 573-2535
Other practice location 1
2051 Charlie Hall Blvd.
Charleston, SC 29414
Phone (843) 573-2535
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5018499 | Other | NC | LICENSURE |
Other names
- Mary Elizabeth Thelan
Other providers in Forest City, NC
- Anna Celeste Swink
- Phillip R. Talbert
- John Parker Tate
- Tonya Taylor
- The Hearing Aid Center, LLC
- Therapy Plus Clinic, Inc.
- Thomas Jefferson Classical Academy
- Sierra Thomas
- Jennifer C Thompson
- Total Renal Care of North Carolina LLC
All providers in Forest City, NC · Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.