NPIMap

Individual provider Active NPI

Amber Henderson Ward, PA-C

  • Medical Physician Assistant
  • Greenville, SC
National Provider Identifier
1275842486
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1573 Issued in SC
Practice address
1 Doctors Dr
Greenville, SC 29605-4266
Phone
(864) 572-7001
Fax
(864) 412-0436
NPI assigned
Oct 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1573 SC Primary

Addresses

Primary practice location

1 Doctors Dr
Greenville, SC 29605-4266

Mailing address

1 Doctors Dr
Greenville, SC 29605-4266
Phone (864) 572-7001

Other identifiers 1

IdentifierTypeStateIssuer
1087PAMedicaidSC

Other names 1

  • Amber Nicole Hendereson 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
I20110310000930 SC Practitioner - Physician Assistant 4688856701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group South Carolina, LLCGroup PAC ID 5395158653, 21 clinicians

Practice addresses (Care Compare)

1 Doctors Dr
Greenville, SC 29605-4266
Phone (864) 572-7001

124 Verdae Blvd
Suite 300
Greenville, SC 29607-3849
Phone (770) 312-5226

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1573SCMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Care, PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: amber.ward.1@29036.direct.athenahealth.com

Organizations & group practices 2

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 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1275842486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054266",
            "telephone_number": "864-572-7001",
            "fax_number": "864-412-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054266",
            "telephone_number": "864-572-7001",
            "fax_number": "864-412-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "AMBER",
        "middle_name": "HENDERSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1087PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "HENDERESON",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.