Ellen Christine Hibberts, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1201 Village Harbor Dr Ste 104
Lake Wylie, SC 29710-9276

Phone

(803) 831-6859

NPI assigned

Jul 6, 2021

Last updated

Nov 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Caromont Medical Group IncGroup PAC ID 3577476258, shared by 2 NPIs, 425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Shelby, NC, CCN 347317
• Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Caromont Medical Group Inc

  dba CaroMont Family Medicine

  • Family Medicine Physician
  • Clover, SC
  • NPI 1568641165
  Medicare reassignment
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272
  Medicare reassignment
• Caromont Medical Group Inc

  dba CaroMont Heart and Vascular

  • Cardiovascular Disease Physician
  • Gastonia, NC
  • NPI 1174813224
  NPD
• Caromont Medical Group Inc

  dba CaroMont Psychiatric Associates

  • Psychiatry Physician
  • Gastonia, NC
  • NPI 1629197744
  NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD
• Emergency Physician Services

  • Radiology Clinic/Center
  • Greenville, SC
  • NPI 1720471618
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gaston Memorial Hospital, Incorporated

  dba CaroMont Regional Medical Center

  • General Acute Care Hospital
  • Gastonia, NC
  • NPI 1013918960
  Care Compare affiliation
• Total Care Home Health of North Carolina, LLC

  dba CenterWell Home Health

  • Home Health Agency
  • Shelby, NC
  • NPI 1649203431
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1245801851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 VILLAGE HARBOR DR STE 104",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297109276",
            "telephone_number": "803-831-6859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Rustic Hills Cir",
            "address_purpose": "LOCATION",
            "city": "Bessemer City",
            "state": "NC",
            "postal_code": "280169545",
            "country_code": "US",
            "telephone_number": "704-689-8189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIBBERTS",
        "first_name": "ELLEN",
        "middle_name": "CHRISTINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glaza Chiropractic Center, Inc
• Al Glaza
• Connor Owen Glaza, DC
• Madison Elizabeth Harkey, OTR/L
• Alan David Hartley, PH.D., DC
• Christine Hogan, MA LPC LCAS CCS
• Robert Anthony Hojnacki, R.P.
• Shannon Howland, D.P,T.
• Jessica Erinn Huren, LMBT
• Amanda C Ivey, FNP-C

• Medical Physician Assistant in Lake Wylie, SC
• Providers in Lake Wylie, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.