Active NPI
Pamela Denise Grant, FNP
- Family Nurse Practitioner
- Hartsville, SC
National Provider Identifier
1538588363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 23887
- Practice address
- 1268 S 4TH St
Hartsville, SC 29550-0703 - Phone
- (843) 332-3422
- Fax
- (843) 332-3985
- NPI assigned
- Apr 9, 2014
- Last updated
- Dec 30, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 23887 | SC | Primary |
Addresses
Primary practice location
1268 S 4TH St
Hartsville, SC 29550-0703
Mailing address
101 Park LN
Chesterfield, SC 29709-8406
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NN0329 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23887 | SC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of South Carolina | Past | Accepting new patients | |
| State of South Carolina Comptroller General | Past | Accepting new patients | |
| Joseph H. Neal Health Collaborative | Past | Accepting new patients | |
| Joseph H. Neal Health Collaborative | Community Health | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/23083/brand/1/csg/1/fhir/r4
- pamela.grant.1@23083.direct.athenahealth.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Joseph H. Neal Community Pharmacy
- Pharmacy
- Columbia, SC
- NPI 1801480405
-
- Family Medicine Physician
- Columbia, SC
- NPI 1972109353
Community Health
-
dba SC Dhec
- Public Health or Welfare Agency
- Bennettsville, SC
- NPI 1184793929
-
dba Veteran Village
- Skilled Nursing Facility
- Florence, SC
- NPI 1336994250
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735516800000",
"number": "1538588363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 PARK LN",
"city": "CHESTERFIELD",
"state": "SC",
"postal_code": "297098406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1268 S 4TH ST",
"city": "HARTSVILLE",
"state": "SC",
"postal_code": "295500703",
"telephone_number": "843-332-3422",
"fax_number": "843-332-3985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "PAMELA",
"middle_name": "DENISE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-09",
"last_updated": "2024-12-30",
"certification_date": "2024-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "23887",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NN0329",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hartsville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.