Active NPI
Serena Wormald Kocourek, NP
- Acute Care Nurse Practitioner
- Greenville, SC
National Provider Identifier
1386274397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 23689
- Practice address
- 1005 Grove Rd
Greenville, SC 29605-4630 - Phone
- (864) 455-6900
- Fax
- (864) 255-5619
- NPI assigned
- Jan 17, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 239287 | SC | |
| Gerontology Nurse Practitioner | 363LG0600X | 23689 | SC | |
| Acute Care Nurse Practitioner | 363LA2100X | 23689 | SC | Primary |
Addresses
Primary practice location
1005 Grove Rd
Greenville, SC 29605-4630
Mailing address
1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6307
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | skocourek167273@direct.ghs.myhfn.org | Direct |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200701003365 | SC | Practitioner - Nurse Practitioner | 5597188912 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
877 W Faris Rd
Suite B
Greenville, SC 29605-4296
Phone (864) 522-6225
Hospital & facility affiliations
- Prisma Health Greenville Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 239287 | SC | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health University Medical Group | Current | Accepting new patients | |
| Prisma Health University Medical Group | Current | Accepting new patients |
Locations
210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123
701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030
877 W Faris Rd
Ste B
Greenville, SC 29605
Phone (864) 522-6225
1005 Grove Rd
Greenville, SC 29605
Phone (864) 235-7665
1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306
2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761
315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550
727 SE Main St
Ste 100
Simpsonville, SC 29681
Phone (864) 454-6520
Interoperability endpoints
- skocourek167273@direct.ghs.myhfn.org
Organizations & group practices 2
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.
-
- Gynecology Physician
- Greer, SC
- NPI 1003619313
Hospital & facility affiliations 39
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Medically Fragile Infants and Children Day Care
- Greenville, SC
- NPI 1093168064
Hospital
-
- Sleep Disorder Diagnostic Clinic/Center
- Greenville, SC
- NPI 1275086431
Hospital
-
- Developmental Disabilities Clinic/Center
- Greenville, SC
- NPI 1336695436
Hospital
-
- Developmental Disabilities Clinic/Center
- Greenville, SC
- NPI 1396291407
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621209600000",
"number": "1386274397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 INDEPENDENCE PT STE 212",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296154536",
"telephone_number": "864-797-6307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 GROVE RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054630",
"telephone_number": "864-455-6900",
"fax_number": "864-255-5619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCOUREK",
"first_name": "SERENA",
"middle_name": "WORMALD",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-17",
"last_updated": "2021-05-17",
"certification_date": "2021-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "239287",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "SC",
"license": "23689",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "SC",
"license": "23689",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "skocourek167273@direct.ghs.myhfn.org",
"affiliation": "N",
"endpointDescription": "skocourek167273@direct.ghs.myhfn.org",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "skocourek167273@direct.ghs.myhfn.org",
"address_1": "1005 Grove Rd",
"city": "Greenville",
"state": "SC",
"country_code": "US",
"postal_code": "296054630",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.