NPIMap

Individual provider Active NPI

Heather M Green, ACNP

  • Acute Care Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1427355940
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AC4454 Issued in SC
Practice address
121 Park Central Dr
Suite 200
Columbia, SC 29203-6476
Phone
(803) 252-9907
Fax
(803) 252-9906
NPI assigned
Feb 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AC4454 SC Primary

Addresses

Primary practice location

121 Park Central Dr
Suite 200
Columbia, SC 29203-6476

Mailing address

121 Park Central Dr
Suite 200
Columbia, SC 29203-6476
Phone (803) 252-9907

Other identifiers 1

IdentifierTypeStateIssuer
AC4454OtherSCACNP LICENSE

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
I20110316000806 SC Practitioner - Nurse Practitioner 3072795715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

115 Atrium Way
Columbia, SC 29223-6371
Phone (839) 200-7800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AC4454SCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Nephrology Associates PA CurrentSince Feb 28, 2011 Accepting new patients
Columbia Nephrology Associates PA CurrentSince Feb 28, 2011 Accepting new patients
Three Rivers Medical Associates, PA Past Accepting new patients

Locations

121 Park Central Dr
Ste 200
Columbia, SC 29203
Phone (803) 252-9907

Interoperability endpoints

  • Direct secure messaging: hgreen380443@direct.musc.edu

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.

Hospital & facility affiliations 12

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": "1297987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1427355940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PARK CENTRAL DR",
            "address_2": "SUITE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036476",
            "telephone_number": "803-252-9907",
            "fax_number": "803-252-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PARK CENTRAL DR",
            "address_2": "SUITE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036476",
            "telephone_number": "803-252-9907",
            "fax_number": "803-252-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "HEATHER",
        "middle_name": "M",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-18",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "AC4454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACNP  LICENSE",
            "identifier": "AC4454",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.