Individual provider Active NPI

Alysha Kaye Chandran, NP

  • Family Nurse Practitioner
  • Seneca, SC
National Provider Identifier
1316320278
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19489 Issued in SC
Practice address
125 Professional Park Dr
Seneca, SC 29678-2558
Phone
(864) 482-3000
Fax
(864) 482-4000
NPI assigned
Jul 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19489 SC Primary

Addresses

Primary practice location

125 Professional Park Dr
Seneca, SC 29678-2558

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidSC

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
I20150901003240 SC Practitioner - Nurse Practitioner 4789990003 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
GHS Partners in Health, Inc. CurrentSince Jul 27, 2015 Accepting new patients
Greenville Health System Current Accepting new patients
Greenville Health System CurrentSince Jul 27, 2015 Accepting new patients
Greenville Health System CurrentSince Jul 27, 2015 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients

Locations

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

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

10110 Clemson Blvd
Seneca, SC 29678
Phone (864) 482-0500

Organizations & group practices 5

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": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1316320278",
    "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": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PROFESSIONAL PARK DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296782558",
            "telephone_number": "864-482-3000",
            "fax_number": "864-482-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDRAN",
        "first_name": "ALYSHA",
        "middle_name": "KAYE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-09",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.