Individual provider Active NPI

Heather Hannon, FNP

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1336699172
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20498 Issued in SC
Practice address
131 Commonwealth Dr
Suite 100
Greenville, SC 29615-4883
Phone
(864) 675-4820
NPI assigned
Oct 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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 20498 SC Primary

Addresses

Primary practice location

131 Commonwealth Dr
Suite 100
Greenville, SC 29615-4883

Mailing address

131 Commonwealth Dr
Suite 100
Greenville, SC 29615-4883
Phone (864) 675-4820

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
I20170718001057 SC Practitioner - Nurse Practitioner 2668742057 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

2755 S Hwy 14
Suite 2200
Greer, SC 29650-4936
Phone (864) 849-9555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20498SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Woodruff Road Urgent Care Center, P.C. Current Accepting new patients
Spartanburg Medical Center CurrentSince Oct 1, 2021 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
St Francis Physician Services Inc CurrentSince Oct 29, 2017 Accepting new patients
Bon Secours Ambulatory Services - St. Francis, LLC CurrentSince May 7, 2017 Accepting new patients
Spartanburg Medical Center CurrentSince Oct 1, 2021 Accepting new patients
St Francis Physician Services Inc CurrentSince Oct 29, 2017 Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

1467 Woodruff Rd
Ste C
Greenville, SC 29607
Phone (864) 458-8126

1200 Brookfield Blvd
Ste 400B
Greenville, SC 29607
Phone (864) 605-3721

2755 S Highway 14
Ste 2200
Greer, SC 29650
Phone (864) 849-9555

100 E Wood St
Spartanburg, SC 29303
Phone (864) 560-7070

Organizations & group practices 8

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1336699172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 COMMONWEALTH DR",
            "address_2": "SUITE 100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154883",
            "telephone_number": "864-675-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 COMMONWEALTH DR",
            "address_2": "SUITE 100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154883",
            "telephone_number": "864-675-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNON",
        "first_name": "HEATHER",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.