Individual provider Active NPI

Rana Hadden Hildebrandt, FNP

  • Nurse Practitioner
  • Okatie, SC
National Provider Identifier
1487980710
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
19363 Issued in SC
Practice address
14 Okatie Center Blvd S Ste 101
Okatie, SC 29909
Phone
(843) 836-3800
Fax
(843) 705-3828
NPI assigned
Oct 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN152808 GA
Nurse Practitioner 363L00000X 19363 SC Primary

Addresses

Primary practice location

14 Okatie Center Blvd S Ste 101
Okatie, SC 29909

Mailing address

14 Okatie Center Blvd S Ste 101
Okatie, SC 29909-7506
Phone (843) 836-3800

Other identifiers 3

IdentifierTypeStateIssuer
P01133812OtherGARAILROAD MEDICARE
003109076DMedicaidGA
003109076CMedicaidGA

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
I20150616002177 SC Practitioner - Nurse Practitioner 5294913299

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN152808GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Urgentone, Inc. Nurse Practitioner Past Accepting new patients
Memorial Health Urgentone, Inc. Nurse Practitioner Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1487980710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 OKATIE CENTER BLVD S STE 101",
            "city": "OKATIE",
            "state": "SC",
            "postal_code": "299097506",
            "telephone_number": "843-836-3800",
            "fax_number": "843-705-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 OKATIE CENTER BLVD S STE 101",
            "city": "OKATIE",
            "state": "SC",
            "postal_code": "29909",
            "telephone_number": "843-836-3800",
            "fax_number": "843-705-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILDEBRANDT",
        "first_name": "RANA",
        "middle_name": "HADDEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN152808",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "19363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01133812",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003109076D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003109076C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okatie, SC

Sources for this page

Verify at the official NPI Registry.