Individual provider Active NPI

Eric T Holberton, PA-C

  • Physician Assistant
  • West Columbia, SC
National Provider Identifier
1477098192
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2683 Issued in SC
Practice address
2728 Sunset Blvd Ste 300
West Columbia, SC 29169-4815
Phone
(803) 744-4940
Fax
(803) 744-4938
NPI assigned
Jan 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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 2683 SC Primary

Addresses

Primary practice location

2728 Sunset Blvd Ste 300
West Columbia, SC 29169-4815

Mailing address

PO Box 6069
West Columbia, SC 29171-6069

Other identifiers 1

IdentifierTypeStateIssuer
TL2683OtherSCSC MEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eholberton57469@direct.lexmed.com

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
I20170315001547 SC Practitioner - Physician Assistant 6709161698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

103 Summit Centre Dr
Columbia, SC 29229-7613
Phone (803) 382-2450

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2460

2728 Sunset Blvd
Suite 105
West Columbia, SC 29169-4839
Phone (803) 936-7095

2728 Sunset Blvd
Suite 300
West Columbia, SC 29169-4815
Phone (803) 744-4900

2728 Sunset Blvd
Suite 400
West Columbia, SC 29169-4872
Phone (803) 936-7095

3314 Platt Springs Rd
West Columbia, SC 29170-2204
Phone (803) 739-9854

5143 Forest Dr
Columbia, SC 29206-4918

5535 Platt Springs Rd
Lexington, SC 29073-7519
Phone (803) 314-9510

557 Columbia Ave
Chapin, SC 29036-8324

565 Columbia Ave
Chapin, SC 29036-8324

811 W Main St
Lexington, SC 29072-2500

Hospital & facility affiliations

  • Lexington Medical Center Hospital, West Columbia, SC, CCN 420073

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2683SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Lexington Health Inc CurrentSince Feb 1, 2021 Accepting new patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

3016 Longtown Commons Dr
Ste 300
Columbia, SC 29229

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

2728 Sunset Blvd
Ste 300
West Columbia, SC 29169
Phone (803) 744-4940

Organizations & group practices 6

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 1

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": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1477098192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 SUNSET BLVD STE 300",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694815",
            "telephone_number": "803-744-4940",
            "fax_number": "803-744-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBERTON",
        "first_name": "ERIC",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC MEDICAL LICENSE",
            "identifier": "TL2683",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eholberton57469@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 300",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.