Active NPI
Stephanie Frison
- Community Health Worker
- Eastover, SC
National Provider Identifier
1396157442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 12171-C07
- Practice address
- 1369 Poultry LN
Eastover, SC 29044-9341 - Phone
- (803) 466-8005
- NPI assigned
- May 23, 2014
- Last updated
- May 23, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 12171-C07 | SC | Primary |
Addresses
Primary practice location
1369 Poultry LN
Eastover, SC 29044-9341
Mailing address
PO Box 323
Eastover, SC 29044-0323
Phone (803) 466-8005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12171-C07 | SC | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400803200000",
"number": "1396157442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 323",
"city": "EASTOVER",
"state": "SC",
"postal_code": "290440323",
"telephone_number": "803-466-8005",
"fax_number": "803-353-3884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1369 POULTRY LN",
"city": "EASTOVER",
"state": "SC",
"postal_code": "290449341",
"telephone_number": "803-466-8005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRISON",
"first_name": "STEPHANIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-23",
"last_updated": "2014-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "SC",
"license": "12171-C07",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastover, SC
- Jerry Rena Delgado, CPHT
- Napoleon Deveaux
- Eau Claire Cooperative Health Center, Inc. (Eastover Cooperative Pharmacy)
- Eau Claire Cooperative Health Center, Inc. (Eastover Cooperative Pharmacy)
- Eau Claire Cooperative Health Center, Inc. (Eastover Family Practice)
- Wanda Kay Fulton, FNP-BC
- GDS Enterprises LLC
- Linda Dawn Jenness-McClellan, PH.D.
- Juveniles Upholding Morals and Priciples of Society
- Marguerite Lovett Knox, NURSE PRACTITIONER
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.