Organization Active NPI

Health Core Medical & Aesthetics Inc

  • Primary Care Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1588445324
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
HEALTH CORE MEDICAL & AESTHETICS INC
Practice address
2992 Reidville Rd Ste 201
Spartanburg, SC 29301-5634
Phone
(864) 319-2535
NPI assigned
Oct 9, 2023
Last updated
Apr 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Authorized official

Name
Tracey Miller, NPNPI 1265818892
Title
Authorized Official/Owner
Phone
(864) 680-8376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X Primary

Addresses

Primary practice location

2992 Reidville Rd Ste 201
Spartanburg, SC 29301-5634

Mailing address

511 Cricket Ridge CT
Duncan, SC 29334-8877
Phone (864) 680-8376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231217000059 SC Part B Supplier - Clinic/Group Practice 6204285109 Receives reassigned benefits from 1 practitioner
Practice locations: Spartanburg, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2293478Health Core Medical& Aesthetics2992 Reidville Road, Suite 5, Spartanburg, SC 29301Certificate of waiverNov 8, 2027

National Provider Directory

National Provider Directory

Locations

2660 Reidville Rd
Ste 5
Spartanburg, SC 29301
Phone (864) 319-2535

2992 Reidville Rd
Ste 201
Spartanburg, SC 29301
Phone (864) 319-2535

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1588445324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 CRICKET RIDGE CT",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293348877",
            "telephone_number": "864-680-8376",
            "fax_number": "864-448-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2992 REIDVILLE RD STE 201",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293015634",
            "telephone_number": "864-319-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CORE MEDICAL & AESTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-09",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/OWNER",
        "authorized_official_telephone_number": "864-680-8376",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.