Individual provider Active NPI

Ann E Reese, NP

  • Gerontology Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1295037919
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4431 Issued in SC
Practice address
255 Enterprise Blvd
Suite 101
Greenville, SC 29615
Phone
(864) 454-8120
Fax
(864) 454-8125
NPI assigned
Dec 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 75752 SC
Gerontology Nurse Practitioner 363LG0600X 4431 SC Primary

Addresses

Primary practice location

255 Enterprise Blvd
Suite 101
Greenville, SC 29615

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8614

Other identifiers 1

IdentifierTypeStateIssuer
NP1752MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address areese11642@direct.ghs.myhfn.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110413000213 SC Practitioner - Nurse Practitioner 5496939688 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
75752SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Current Accepting new patients
Prisma Health University Medical Group Nurse Practitioner CurrentSince Jan 16, 2011 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 16, 2011 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

255 Enterprise Blvd
Ste 101
Greenville, SC 29615
Phone (864) 297-4929

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

7 Independence Pt
Ste 100
Greenville, SC 29615
Phone (864) 797-6106

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: areese11642@direct.ghs.myhfn.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1295037919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 ENTERPRISE BLVD",
            "address_2": "SUITE 101",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29615",
            "telephone_number": "864-454-8120",
            "fax_number": "864-454-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "ANN",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-01",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "75752",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "4431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1752",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "areese11642@direct.ghs.myhfn.org",
            "affiliation": "N",
            "address_1": "255 Enterprise Blvd",
            "address_2": "Suite 101",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.