Individual provider Active NPI

Emily Herndon, FNP

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1457905010
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23049 Issued in SC
Practice address
1 Doctors Dr
Greenville, SC 29605-4266
Phone
(864) 572-7001
Fax
(864) 412-0436
NPI assigned
Jul 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23049 SC Primary

Addresses

Primary practice location

1 Doctors Dr
Greenville, SC 29605-4266

Mailing address

1 Doctors Dr
Greenville, SC 29605-4266
Phone (864) 572-7001

Other identifiers 1

IdentifierTypeStateIssuer
NP6185MedicaidSC

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
I20191022003936 SC Practitioner - Nurse Practitioner 2062744188 Reassigns benefits to 2 organizations

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
Privia Medical Group South Carolina, LLCGroup PAC ID 5395158653, 21 clinicians

Practice addresses (Care Compare)

1 Doctors Dr
Greenville, SC 29605-4266
Phone (864) 572-7001

Hospital & facility affiliations

  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23049SCMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Sep 1, 2019 Accepting new patients
Privia Medical Group South Carolina, LLC CurrentSince Apr 1, 2021 Accepting new patients
Prisma Health University Medical Group CurrentSince Sep 1, 2019 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

124 Verdae Blvd
Ste 300
Greenville, SC 29607

1 Doctors Dr
Greenville, SC 29605
Phone (864) 271-3354

200 Patewood Dr
Ste B400
Greenville, SC 29615
Phone (864) 454-4368

Interoperability endpoints

  • Direct secure messaging: emily.herndon.1@29036.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/29036/brand/1/csg/1/fhir/r4

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 6

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": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1457905010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054266",
            "telephone_number": "864-572-7001",
            "fax_number": "864-412-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054266",
            "telephone_number": "864-572-7001",
            "fax_number": "864-412-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "EMILY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP6185",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.