Individual provider Active NPI

Madeline Reistroffer, ANP

  • Adult Health Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1194721464
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
62680 Issued in SC
Practice address
1330 Boiling Springs Rd Ste 2100
Spartanburg, SC 29303-4210
Phone
(864) 591-1700
Fax
(864) 591-0007
NPI assigned
Jun 22, 2005
Last updated
Feb 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 62680 SC Primary

Addresses

Primary practice location

1330 Boiling Springs Rd Ste 2100
Spartanburg, SC 29303-4210

Mailing address

391 Serpentine Dr
Ste 500
Spartanburg, SC 29303-3096
Phone (864) 585-8221

Other identifiers 1

IdentifierTypeStateIssuer
NP0178MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231207002875 NY Practitioner - Nurse Practitioner 7810881059 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1609SCMDOptician
62680SCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Past Accepting new patients
Palmetto Hematology Oncology PC Past Accepting new patients
Upstate Carolina Radiology PA PastSince Nov 1, 2016 Accepting new patients
Palmetto Hematology Oncology PC Past Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Organizations & group practices 7

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1194721464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 SERPENTINE DR",
            "address_2": "STE 500",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033096",
            "telephone_number": "864-585-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD STE 2100",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034210",
            "telephone_number": "864-591-1700",
            "fax_number": "864-591-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISTROFFER",
        "first_name": "MADELINE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "62680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0178",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.