Patrick Lee Nettles II, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3740 Issued in SC

Practice address

12 W South St
Manning, SC 29102-2925

Phone

(803) 433-4124

Fax

(803) 433-0074

NPI assigned

Nov 4, 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

Enrolled in SC

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 1

Specialty

Physician Assistant

Education

Medical University of South Carolina College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis Healthcare, IncGroup PAC ID 4688869696, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: patrick.nettles.1@20108.direct.athenahealth.com
• Direct secure messaging: patrick.nettles.1@17752.direct.athenahealth.com
• FHIR API: https://fhir4.healow.com/fhir/r4/BHIEAD
• Direct secure messaging: patrick.nettles.1@18007.direct.athenahealth.com

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.

• Genesis Healthcare, Inc.

  dba Pee Dee Health Care

  • Federally Qualified Health Center (FQHC)
  • Darlington, SC
  • NPI 1437484862
  Medicare reassignment Care Compare group
• Hopehealth Inc

  dba HopeHealth Dental Palmetto

  • Federally Qualified Health Center (FQHC)
  • Florence, SC
  • NPI 1821002411
  Medicare reassignment
• Genesis Healthcare, Inc.

  dba Lamar Family Care

  • Federally Qualified Health Center (FQHC)
  • Lamar, SC
  • NPI 1538543723
  NPD
• Genesis Healthcare, Inc.

  dba Mobile Health Clinic #1

  • Federally Qualified Health Center (FQHC)
  • Walterboro, SC
  • NPI 1881440758
  NPD
• Hopehealth Inc

  dba HopeHealth J. Paul Truluck School-based Health Center

  • Federally Qualified Health Center (FQHC)
  • Lake City, SC
  • NPI 1649069618
  NPD
• Hopehealth, Inc

  dba HopeHealth Manning Pediatrics

  • Federally Qualified Health Center (FQHC)
  • Manning, SC
  • NPI 1013259712
  NPD
• Genesis Healthcare, Inc.

  dba Genesis Healthcare Florence

  • Federally Qualified Health Center (FQHC)
  • Florence, SC
  • NPI 1255305280
  NPD (past)

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1285235457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W SOUTH ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291022925",
            "telephone_number": "803-433-4124",
            "fax_number": "803-433-0074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Cashua St",
            "address_purpose": "LOCATION",
            "city": "Darlington",
            "state": "SC",
            "postal_code": "295323301",
            "country_code": "US",
            "telephone_number": "843-393-7452",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Exchange St",
            "address_purpose": "LOCATION",
            "city": "Darlington",
            "state": "SC",
            "postal_code": "295323203",
            "country_code": "US",
            "telephone_number": "843-393-9421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NETTLES",
        "first_name": "PATRICK",
        "middle_name": "LEE",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-04",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deepthy Prabha Narayana, MD
• Amanda Jean Nedervelt, D.O.
• Tracy Neill, PHYSICAL THERAPIST
• Tonya M. Nelson
• Marlisa Nesmith
• New Beginnings Counseling Center LLC
• New Hope Home Care
• Amber Newman, APRN
• Martha Elaine Norsworthy, PHARMD
• Ann Marie Norton, RN, NP

• Physician Assistant in Manning, SC
• Providers in Manning, 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 Jul 17, 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.
• 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.