Individual provider Active NPI

Bethany C Boyd, FNP

  • Family Nurse Practitioner
  • Clemson, SC
National Provider Identifier
1467832154
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19513 Issued in SC
Practice address
885 Tiger Blvd
Clemson, SC 29631-1480
Phone
(864) 512-5890
Fax
(864) 512-4711
NPI assigned
Jun 8, 2015
Last updated
Nov 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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 19513 SC Primary

Addresses

Primary practice location

885 Tiger Blvd
Clemson, SC 29631-1480

Mailing address

PO Box 100174
Columbia, SC 29202-3174
Phone (864) 512-5890

Other practice location 1

895 Tiger Blvd
Clemson, SC 29631
Phone (864) 512-7257

Other identifiers 2

IdentifierTypeStateIssuer
19513OtherSCMEDICAL LICENSE
NP3418MedicaidSC

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
I20150807015492 SC Practitioner - Nurse Practitioner 6800100546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19513SCMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: bboyd39683@direct.anmedhealth.net

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1467832154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100174",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292023174",
            "telephone_number": "864-512-5890",
            "fax_number": "864-512-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 TIGER BLVD",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311480",
            "telephone_number": "864-512-5890",
            "fax_number": "864-512-4711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "895 Tiger Blvd",
            "address_purpose": "LOCATION",
            "city": "Clemson",
            "state": "SC",
            "postal_code": "29631",
            "country_code": "US",
            "telephone_number": "864-512-7257",
            "fax_number": "864-654-7672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "BETHANY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "19513",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3418",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemson, SC

Sources for this page

Verify at the official NPI Registry.