NPIMap

Individual provider Active NPI

Elizabeth Ann Perry, PA-C

  • Physician Assistant
  • Spartanburg, SC
National Provider Identifier
1467114181
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4163 Issued in SC
Practice address
1690 Skylyn Dr Ste 300a
Spartanburg, SC 29307-1022
Phone
(864) 342-4000
Fax
(864) 585-2488
NPI assigned
Oct 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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 4163 SC Primary

Addresses

Primary practice location

1690 Skylyn Dr Ste 300a
Spartanburg, SC 29307-1022

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other identifiers 2

IdentifierTypeStateIssuer
4819PAMedicaidSC
SCL4975019OtherSCMEDICARE PIN

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
I20211102000982 SC Practitioner - Physician Assistant 1456749977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

101 E Wood St
Spartanburg, SC 29303-3040

853 N Church St
Suite 410a
Spartanburg, SC 29303-3098
Phone (864) 560-6928

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4163SCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Mar 1, 2024 Accepting new patients
Spartanburg Medical Center Past Accepting new patients
Village Hospital Past Accepting new patients

Locations

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 4

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 7

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": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1467114181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 SKYLYN DR STE 300A",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071022",
            "telephone_number": "864-342-4000",
            "fax_number": "864-585-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-11",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4819PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCL4975019",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.