Individual provider Active NPI

Amanda M. Merchant, M.D.

  • Pediatrics Physician
  • Greenville, SC
National Provider Identifier
1205977105
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20919 Issued in SC
Practice address
200 Patewood Dr
Suite A200
Greenville, SC 29615-3593
Phone
(864) 454-5115
NPI assigned
Feb 12, 2007
Last updated
Oct 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20919 SC Primary

Addresses

Primary practice location

200 Patewood Dr
Suite A200
Greenville, SC 29615-3593

Mailing address

1 Independence PT
Ste 212
Greenville, SC 29615-4545
Phone (864) 797-6306

Other identifiers 1

IdentifierTypeStateIssuer
209198MedicaidSC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100614000254 SC Practitioner - Pediatric Medicine 3779613088 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20919SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Nov 3, 2014 Accepting new patients
Greenville Health System CurrentSince Nov 3, 2014 Accepting new patients
Prisma Health University Medical Group Pediatrics CurrentSince Nov 3, 2014 Accepting new patients
Greenville Health System Current Accepting new patients
New Horizon Family Health Services Inc Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

200 Patewood Dr
Ste A200
Greenville, SC 29615
Phone (864) 454-5115

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

830 S Buncombe Rd
Greer, SC 29650
Phone (864) 797-8000

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Organizations & group practices 5

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1205977105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6306",
            "fax_number": "864-797-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR",
            "address_2": "SUITE A200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153593",
            "telephone_number": "864-454-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "AMANDA",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "20919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209198",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.