Individual provider Active NPI

Elizabeth Hammond, C.P.N.P.

  • Pediatric Nurse Practitioner
  • Greenwood, SC
National Provider Identifier
1508870635
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
22080 Issued in SC
Practice address
210 Wells Ave
Greenwood, SC 29646-3843
Phone
(864) 943-4279
Fax
(864) 223-2642
NPI assigned
Jul 27, 2006
Last updated
Dec 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 22080 SC Primary

Addresses

Primary practice location

210 Wells Ave
Greenwood, SC 29646-3843

Mailing address

210 Wells Ave
Greenwood, SC 29646-3843
Phone (864) 943-4279

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ehammond247031@selfregional.direct-ci.net

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
I20181210000682 SC Practitioner - Nurse Practitioner 9133463730 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Self Regional Healthcare CurrentSince Sep 22, 2025 Accepting new patients
Self Regional Healthcare CurrentSince Sep 22, 2025 Accepting new patients
Self Regional Healthcare Current Accepting new patients
Self Medical Group CurrentSince Nov 12, 2018 Accepting new patients
Self Medical Group CurrentSince Nov 12, 2018 Accepting new patients
Self Medical Group Current Accepting new patients
Snellville Pediatrics, P.C. PastSince Jul 24, 2022 Accepting new patients
Self Regional Healthcare Past Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

75 Remittance Dr
Dept 6793
Chicago, IL 60675

102 Katie Ct
Greenwood, SC 29646
Phone (864) 227-2022

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

210 Wells Ave
Greenwood, SC 29646
Phone (864) 227-2020

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Interoperability endpoints

  • Direct secure messaging: ehammond247031@selfregional.direct-ci.net
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72215

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1508870635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WELLS AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463843",
            "telephone_number": "864-943-4279",
            "fax_number": "864-223-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WELLS AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463843",
            "telephone_number": "864-943-4279",
            "fax_number": "864-223-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOND",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "22080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehammond247031@selfregional.direct-ci.net",
            "affiliation": "N",
            "address_1": "210 Wells Ave",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296463843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.