Individual provider Active NPI

Alexandra Mary Hallett, PA-C

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1407623879
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
201 Rocky Slope Rd Apt 910
Greenville, SC 29607-3953
Phone
(952) 607-9408
NPI assigned
Dec 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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 SC Primary

Addresses

Primary practice location

201 Rocky Slope Rd Apt 910
Greenville, SC 29607-3953

Mailing address

201 Rocky Slope Rd Apt 910
Greenville, SC 29607-3953
Phone (952) 607-9408

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
I20240206000169 SC Practitioner - Physician Assistant 7719320886 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5163SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Jan 18, 2024 Accepting new patients
Pelham Medical Center CurrentSince Jan 18, 2024 Accepting new patients
Pelham Medical Center CurrentSince Jan 18, 2024 Accepting new patients
Spartanburg Medical Center CurrentSince Jan 18, 2024 Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

Organizations & group practices 6

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": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1407623879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ROCKY SLOPE RD APT 910",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073953",
            "telephone_number": "952-607-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ROCKY SLOPE RD APT 910",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073953",
            "telephone_number": "952-607-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLETT",
        "first_name": "ALEXANDRA",
        "middle_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-06",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.