Pamela J Ridley, APRN, BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Rock Hill, SC
NPI 1255409132 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1255409132
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 2386 (SC)
- Practice address
- 2400 W Main St
Rock Hill, SC 29732-8968 - Phone
- (803) 327-6103
- Fax
- (803) 328-5443
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Vanderbilt University School of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Charleston Counseling Center PC
Practice addresses (Care Compare)
502 Cherry Rd
Rock Hill, SC 29732-3118
Phone (843) 501-1099
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221020000395 | SC | Practitioner - Nurse Practitioner | 6204202930 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Specialist, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2386 | SC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charleston Counseling Center PC | Current |
Accepting new patients | |
| Tandem Health SC | Current |
Accepting new patients | |
| Tandem Health SC | Current |
Accepting new patients | |
| Tandem Health SC | Current |
Accepting new patients | |
| Amisub of South Carolina, Inc. | Past | Accepting new patients | |
| Amisub of South Carolina, Inc. | Past | Accepting new patients | |
| Myrtle Beach Counseling Center | Past |
Accepting new patients | |
| The Saluda Counseling Services Center Inc. | Psychiatric/Mental Health | Past |
Accepting new patients |
Locations
871 Lowcountry Blvd
Ste 200
Mt Pleasant, SC 29464
Phone (253) 346-0137
25 E Clark St
Pinewood, SC 29125
Phone (803) 452-5151
502 Cherry Rd
Rock Hill, SC 29732
Phone (839) 213-6425
502 Cherry Rd
Ste 201
Rock Hill, SC 29732
Phone (678) 763-5994
1278 N Layfayette St
Sumter, SC 29150
425 N Salem Ave
Sumter, SC 29150
Phone (803) 773-8148
550 S Pike W
Sumter, SC 29150
Interoperability endpoints
- lifestancehealth.pamelaridley@149035.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2386 | SC | Yes |
Addresses
Primary practice location
2400 W Main St
Rock Hill, SC 29732-8968
Mailing address
1630 Bowater Rd
Rock Hill, SC 29732-9508
Phone (803) 366-5375
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 570629234005 | Other | SC | BCBS |
Other providers in Rock Hill, SC
- India Blandon Richardson
- Scott C Richardson
- Talaya Levone Richmond
- Richard Lester Richter
- Regan Riddle
- Right Steps LLC
- Right Steps LLC
- Debra Nicole Riley
- Meleane Riley
- Marjorie J Risser
All providers in Rock Hill, SC · Psychiatric/Mental Health Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.