NPIMap

Individual provider Active NPI

Rebekah Lynn Gardner, PA-C

  • Surgical Physician Assistant
  • Greenwood, SC
National Provider Identifier
1245995653
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4199 Issued in SC
Practice address
115 Academy Ave
Greenwood, SC 29646-3869
Phone
(864) 725-7272
Fax
(864) 725-5799
NPI assigned
Nov 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4199 SC Primary

Addresses

Primary practice location

115 Academy Ave
Greenwood, SC 29646-3869

Mailing address

115 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-7272

Other names 1

  • Rebekah Lynn Allison Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220325001033 SC Practitioner - Physician Assistant 2961897152 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians
Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians

Practice addresses (Care Compare)

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111

155 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-4865

160 Academy Ave
Greenwood, SC 29646-3808
Phone (864) 223-8090

Hospital & facility affiliations

  • Home Health Services of Self Regional Healthcare Home health agency, Greenwood, SC, CCN 427018
  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4199SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group CurrentSince Jan 17, 2022 Accepting new patients
Self Medical Group CurrentSince Jan 17, 2022 Accepting new patients
Self Regional Healthcare CurrentSince Feb 2, 2026 Accepting new patients
Self Regional Healthcare CurrentSince Feb 2, 2026 Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients
Self Medical Group Past Accepting new patients
Self Regional Healthcare Past Accepting new patients

Locations

75 Remittance Dr
Dept 6793
Chicago, IL 60675

75 Remittance Dr
Dept 6764
Chicago, IL 60675

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

115 Academy Ave
Greenwood, SC 29646
Phone (864) 725-7272

22580 Highway 76 E
Ste 200
Laurens, SC 29360
Phone (864) 725-1480

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Interoperability endpoints

  • Direct secure messaging: rgardner537275@selfregional.direct-ci.net

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1245995653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463869",
            "telephone_number": "864-725-7272",
            "fax_number": "864-725-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463869",
            "telephone_number": "864-725-7272",
            "fax_number": "864-725-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "REBEKAH",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "4199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBEKAH",
            "last_name": "ALLISON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.