NPIMap

Individual provider Active NPI

Caroline Eberhardt Edwards, PA-C

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1356080055
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
975 W Faris Rd
Greenville, SC 29605-4241
Phone
(864) 729-8330
NPI assigned
Jun 1, 2022
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

975 W Faris Rd
Greenville, SC 29605-4241

Mailing address

975 W Faris Rd
Greenville, SC 29605-4241
Phone (864) 729-8330

Other practice location 1

111A Berry Ave
Greer, SC 29651-1307
Phone (864) 801-2035

Other names 1

  • Caroline Marie Eberhardt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240502003742 SC Practitioner - Physician Assistant 2567802812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 A Berry Ave
Greer, SC 29651-1307
Phone (864) 801-2035

130 Mallard St
Greenville, SC 29601-4046
Phone (864) 233-1534

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5000SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizon Family Health Services, Inc. CurrentSince Feb 14, 2024 Accepting new patients
New Horizon Family Health Services Inc CurrentSince Feb 14, 2024 Accepting new patients
New Horizon Family Health Services Inc. PastSince Sep 10, 2023 Accepting new patients

Locations

130 Mallard St
Greenville, SC 29601
Phone (864) 233-1534

975 W Faris Rd
Greenville, SC 29605
Phone (864) 729-8330

111A Berry Ave
Greer, SC 29651
Phone (864) 801-2035

Interoperability endpoints

  • Direct secure messaging: caroline.eberhardt.1@10133.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1356080055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054241",
            "telephone_number": "864-729-8330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054241",
            "telephone_number": "864-729-8330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111A Berry Ave",
            "address_purpose": "LOCATION",
            "city": "Greer",
            "state": "SC",
            "postal_code": "296511307",
            "country_code": "US",
            "telephone_number": "864-801-2035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CAROLINE",
        "middle_name": "EBERHARDT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "EBERHARDT",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.