Benjamin N.H. Haddock, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

115 Brushy Creek Rd
Easley, SC 29642-1120

Phone

(864) 635-0376

Fax

(864) 442-6848

NPI assigned

Aug 14, 2020

Sex

Male

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• Carolina Spine Pain LLC

  • Pain Medicine Physician
  • Easley, SC
  • NPI 1447918230
  NPD

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1265043004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1315",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296411315",
            "telephone_number": "864-635-0376",
            "fax_number": "864-442-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BRUSHY CREEK RD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296421120",
            "telephone_number": "864-635-0376",
            "fax_number": "864-442-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOCK",
        "first_name": "BENJAMIN",
        "middle_name": "N.H.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Patrick Grejda
• Elizabeth Griffin, R.N.
• Rebecca Ann Guthrie, LPN
• Nicole Trista Guttermuth, MA, MED, NCC, LPC
• Julie Ann Haas, DVM
• John Hajovsky, DPT
• Darlene Hall, COTA/L
• Kathy Hall, COTA
• Marlesia Hall
• Ruby Hall, PTA

• Physician Assistant in Easley, SC
• Providers in Easley, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.