NPIMap

Individual provider Active NPI

Elizabeth B Greene, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1477935468
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
19576 Issued in SC
Practice address
1690 Skylyn Dr Ste 300a
Spartanburg, SC 29307-1022
Phone
(864) 424-0003
Fax
(864) 585-2488
NPI assigned
Jun 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 19576 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
NP8279MedicaidSC
SC68855019OtherSCMEDICARE PIN

Other names 1

  • Elizabeth Lee Boozer Former name

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
I20151107000237 SC Practitioner - Nurse Practitioner 7416267257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
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)

1690 Skylyn Dr
Suite 300a
Spartanburg, SC 29307-1022
Phone (864) 342-4000

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19576SCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Mar 1, 2022 Accepting new patients
Spartanburg Medical Center CurrentSince Mar 1, 2022 Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

2755 S Highway 14
Ste 2350
Greer, SC 29650
Phone (864) 583-8647

1690 Skylyn Dr
Ste 300A
Spartanburg, SC 29307
Phone (864) 342-4000

1690 Skylyn Dr
Ste 230
Spartanburg, SC 29307
Phone (864) 583-8647

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

1083 Boiling Springs Rd
Spartanburg, SC 29303
Phone (803) 583-8647

1075 Boiling Springs Rd
Ste A
Spartanburg, SC 29303
Phone (864) 583-8647

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 8

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1477935468",
    "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": "864-424-0003",
            "fax_number": "864-585-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "ELIZABETH",
        "middle_name": "B",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "19576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP8279",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC68855019",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "BOOZER",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.