Individual provider Active NPI

Elizabeth Harleston, M.D.

  • Family Medicine Physician
  • Elgin, SC
National Provider Identifier
1194089789
Registry record updated Apr 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD34758 Issued in SC
Practice address
40 Pinnacle Pkwy
Suite 212
Elgin, SC 29045-8390
Phone
(803) 424-5161
Fax
(803) 424-5795
NPI assigned
Jun 27, 2012
Last updated
Apr 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL34758 SC
Family Medicine Physician 207Q00000X MD34758 SC Primary

Addresses

Primary practice location

40 Pinnacle Pkwy
Suite 212
Elgin, SC 29045-8390

Mailing address

40 Pinnacle Pkwy
Suite 212
Elgin, SC 29045-8390
Phone (803) 424-5161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140718002085 SC Practitioner - Family Practice 1052537511 Reassigns benefits to 1 organization
I20180907000245 CA Practitioner - Family Practice 1052537511 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL34758SCMDFamily Medicine Physician
MD34758SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Torrance Health Association Inc Family Medicine CurrentSince Sep 24, 2018 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Family Medicine CurrentSince May 12, 2014 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince May 12, 2014 Accepting new patients

Locations

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

3701 Skypark Dr
Ste 100
Torrance, CA 90505
Phone (310) 378-2234

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

Organizations & group practices 3

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1194089789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PINNACLE PKWY",
            "address_2": "SUITE 212",
            "city": "ELGIN",
            "state": "SC",
            "postal_code": "290458390",
            "telephone_number": "803-424-5161",
            "fax_number": "803-424-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 PINNACLE PKWY",
            "address_2": "SUITE 212",
            "city": "ELGIN",
            "state": "SC",
            "postal_code": "290458390",
            "telephone_number": "803-424-5161",
            "fax_number": "803-424-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLESTON",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL34758",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "MD34758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, SC

Sources for this page

Verify at the official NPI Registry.