Individual provider Active NPI

Charlotte H. Hanna, PA-C

  • Medical Physician Assistant
  • Florence, SC
National Provider Identifier
1508429317
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3195 Issued in SC
Practice address
800 E Cheves St Ste 380
Florence, SC 29506-2649
Phone
(843) 665-4104
Fax
(843) 777-7565
NPI assigned
Apr 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3195 SC Primary

Addresses

Primary practice location

800 E Cheves St Ste 380
Florence, SC 29506-2649

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 665-4104

Other identifiers 1

IdentifierTypeStateIssuer
3208PAMedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charlotte.hanna@mpaii.eclinicaldirectplus.com Direct

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
I20190626002401 SC Practitioner - Physician Assistant 1153654082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Physician Associates II 541 clinicians

Practice addresses (Care Compare)

800 E Cheves St
Florence, SC 29506-2650

800 E Cheves St
Florence, SC 29506-2652

Hospital & facility affiliations

  • McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3195SCMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II CurrentSince Nov 23, 2020 Accepting new patients
McLeod Physician Associates II Past Accepting new patients

Locations

506 E Cheves St
#202
Florence, SC 29506

Interoperability endpoints

  • Direct secure messaging: channa22974@directmcleodehealth.org

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 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": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1508429317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-665-4104",
            "fax_number": "843-777-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CHEVES ST STE 380",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062649",
            "telephone_number": "843-665-4104",
            "fax_number": "843-777-7565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "CHARLOTTE",
        "middle_name": "H.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "3195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3208PA",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlotte.hanna@mpaii.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "ECW DA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "800 E Cheves St Ste 380",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295062649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.