Individual provider Active NPI

Amanda Elizabeth Hare, ARNP

  • Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1245748029
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
21225 Issued in SC
Practice address
96 Jonathan Lucas St
Charleston, SC 29425
Phone
(843) 792-3224
NPI assigned
Jan 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP9475974 FL
Nurse Practitioner 363L00000X 21225 SC Primary

Addresses

Primary practice location

96 Jonathan Lucas St
Charleston, SC 29425

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Other practice location 1

Medical University Of South Carolina
Charleston, SC 29425
Phone (843) 792-2300

Other practice location 2

96 Jonathan Lucas St
Charleston, SC 29425
Phone (843) 792-3224

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
I20190403000571 SC Practitioner - Nurse Practitioner 9638410574 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PPCP Specialty Physicians , LLCGroup PAC ID 2466723028, 20 clinicians

Practice addresses (Care Compare)

5500 Front St
Suite 230
Summerville, SC 29486-8140
Phone (843) 572-7727

Hospital & facility affiliations

  • Trident Medical Center Hospital, Charleston, SC, CCN 420079
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9475974FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PPCP Specialty Physicians , LLC Current Accepting new patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
PPCP Specialty Physicians, LLC CurrentSince Apr 10, 2023 Accepting new patients
PPCP Specialty Physicians , LLC CurrentSince Apr 10, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol Nurse Practitioner CurrentSince Feb 14, 2019 Accepting new patients

Locations

96 Jonathan Lucas St
Charleston, SC 29425
Phone (843) 792-3072

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

7 S Alliance Dr
Ste 202A
Goose Creek, SC 29445
Phone (843) 376-6070

5500 Front St
Ste 230
Summerville, SC 29486
Phone (843) 569-1856

Interoperability endpoints

  • Direct secure messaging: amanda.hare@ppcp1.eclinicaldirectplus.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1245748029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-3224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Medical University Of South Carolina",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "29425",
            "country_code": "US",
            "telephone_number": "843-792-2300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "96 Jonathan Lucas St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "29425",
            "country_code": "US",
            "telephone_number": "843-792-3224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARE",
        "first_name": "AMANDA",
        "middle_name": "ELIZABETH",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9475974",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "21225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.