Individual provider Active NPI

Anna Fulghum Ehrhardt, MD

  • Psychiatry Physician
  • Charleston, SC
National Provider Identifier
1457628463
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
LL82898 Issued in SC
Practice address
2100 Charlie Hall Blvd
Charleston, SC 29414-5832
Phone
(843) 852-4100
NPI assigned
Nov 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X LL82898 SC Primary

Addresses

Primary practice location

2100 Charlie Hall Blvd
Charleston, SC 29414-5832

Mailing address

67 President St
Charleston, SC 29425-5129
Phone (843) 792-2300

Other identifiers 2

IdentifierTypeStateIssuer
1760596480MedicaidSC
LL82898OtherSCSC MEDICAL LICENSE

Other names 1

  • Anna R Fulghum Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jun 18, 2024 through Jun 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Falls Church Therapy Associates Psychiatry PastSince May 7, 2024 Accepting new patients

Organizations & group practices 1

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": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1457628463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 PRESIDENT ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294255129",
            "telephone_number": "843-792-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145832",
            "telephone_number": "843-852-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRHARDT",
        "first_name": "ANNA",
        "middle_name": "FULGHUM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-18",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "LL82898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760596480",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC MEDICAL LICENSE",
            "identifier": "LL82898",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "FULGHUM",
            "middle_name": "R",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.