Individual provider Active NPI

Elizabeth Amber Haselden, FNP-C

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1205359502
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21276 Issued in SC
Practice address
111 Doctor Cir
Columbia, SC 29203-6502
Phone
(800) 491-0909
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21276 SC Primary

Addresses

Primary practice location

111 Doctor Cir
Columbia, SC 29203-6502

Mailing address

111 Doctor Cir
Columbia, SC 29203-6502
Phone (800) 491-0909

Other identifiers 1

IdentifierTypeStateIssuer
NP4904MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20181007000024 SC Practitioner - Nurse Practitioner 6002168853 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SC House Calls IncGroup PAC ID 6800994807, 445 clinicians

Practice addresses (Care Compare)

1053 Ctr St
West Columbia, SC 29169-6749
Phone (800) 491-0909

Hospital & facility affiliations

  • Amedisys Home Health of Lexington Home health agency, Lexington, SC, CCN 427039
  • Centerwell Home Health-Pee Dee Home health agency, Florence, SC, CCN 427854

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21276SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SC House Calls Inc CurrentSince Aug 25, 2020 Accepting new patients
McLeod Health Cheraw CurrentSince Sep 20, 2021 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Jul 28, 2019 Accepting new patients
SC House Calls Inc CurrentSince Aug 25, 2020 Accepting new patients
McLeod Health Cheraw CurrentSince Sep 20, 2021 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Jul 28, 2019 Accepting new patients

Locations

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

111 Doctor Cir
Columbia, SC 29203
Phone (803) 730-8910

1624 Main St
Columbia, SC 29201
Phone (803) 454-0365

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

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

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

Interoperability endpoints

  • Direct secure messaging: elizabeth.haselden.1@7602.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1205359502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASELDEN",
        "first_name": "ELIZABETH",
        "middle_name": "AMBER",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4904",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.