NPIMap

Individual provider Active NPI

Hanna Rose

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1174974372
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2510 Issued in SC
Practice address
975 W Faris Rd
Greenville, SC 29605-4241
Phone
(864) 729-8330
NPI assigned
Jun 29, 2016
Last updated
Jan 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2510 SC Primary

Addresses

Primary practice location

975 W Faris Rd
Greenville, SC 29605-4241

Mailing address

975 W Faris Rd
Greenville, SC 29605-4241
Phone (864) 729-8330

Other identifiers 3

IdentifierTypeStateIssuer
2669PAMedicaidSC
SC84368510OtherSCMEDICARE PIN
SC84369068OtherSCMEDICARE PIN

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
I20160801000027 SC Practitioner - Physician Assistant 9830482736 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Baylor College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 A Berry Ave
Greer, SC 29651-1307
Phone (864) 801-2035

130 Mallard St
Greenville, SC 29601-4046
Phone (864) 233-1534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2510SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Feb 16, 2019 Accepting new patients
New Horizon Family Health Services, Inc. CurrentSince Aug 11, 2024 Accepting new patients
Piedmont Pathology Associates PA Current Accepting new patients
New Horizon Family Health Services Inc CurrentSince Aug 11, 2024 Accepting new patients
Diagnostic Radiology of Anderson, P.a. Current Accepting new patients
Spartanburg Medical Center CurrentSince Feb 16, 2019 Accepting new patients
Pelham Medical Center CurrentSince Feb 16, 2019 Accepting new patients
New Horizon Family Health Services Inc. PastSince Sep 10, 2023 Accepting new patients

Locations

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

130 Mallard St
Greenville, SC 29601
Phone (864) 233-1534

975 W Faris Rd
Greenville, SC 29605
Phone (864) 729-8330

250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Interoperability endpoints

  • Direct secure messaging: hanna.brummitt.1@10133.direct.athenahealth.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1174974372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054241",
            "telephone_number": "864-729-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054241",
            "telephone_number": "864-729-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "HANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2669PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC84368510",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC84369068",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.