Individual provider Active NPI

Pamela Lynn Eliason, APRN-BC

  • Family Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1346453065
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
218 Issued in SC
Practice address
96 Jonathan Lucas St
CSB 903
Charleston, SC 29425-8900
Phone
(843) 792-2123
Fax
(843) 792-0644
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 218 SC Primary

Addresses

Primary practice location

96 Jonathan Lucas St
CSB 903
Charleston, SC 29425-8900

Mailing address

577 Travelers Blvd
Summerville, SC 29485-8220
Phone (843) 875-2412

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
I20140408000305 SC Practitioner - Nurse Practitioner 4688806565 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
218SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Hospital Inc. CurrentSince Jan 11, 2014 Accepting new patients
Roper Hospital, Inc. CurrentSince Jan 11, 2014 Accepting new patients
Roper Hospital, Inc. Current Accepting new patients

Locations

416 Robertson Blvd
Ste B
Walterboro, SC 29488
Phone (843) 549-2411

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346453065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 TRAVELERS BLVD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858220",
            "telephone_number": "843-875-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS ST",
            "address_2": "CSB 903",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258900",
            "telephone_number": "843-792-2123",
            "fax_number": "843-792-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIASON",
        "first_name": "PAMELA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.