Individual provider Active NPI

Emily Dugger Hersel, PA-C

  • Physician Assistant
  • Easley, SC
National Provider Identifier
1619367109
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2980 Issued in SC
Practice address
115 Whitmire Rd
Easley, SC 29640
Phone
(864) 855-2411
Fax
(864) 855-2413
NPI assigned
Feb 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2980 SC Primary
Physician Assistant 363A00000X 007499 GA

Addresses

Primary practice location

115 Whitmire Rd
Easley, SC 29640

Mailing address

115 Whitmire Rd
Easley, SC 29640-1426
Phone (864) 855-2411

Other identifiers 3

IdentifierTypeStateIssuer
602-05779OtherALBCBS-AL
003157530AMedicaidGA
169289MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151007000221 GA Practitioner - Physician Assistant 4082922372 Reassigns benefits to 1 organization
I20190306001659 SC Practitioner - Physician Assistant 4082922372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Alabama School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Easley Head and Neck Surgery PAGroup PAC ID 4981767753, 3 clinicians

Practice addresses (Care Compare)

115 Whitmire Rd
Easley, SC 29640-1426
Phone (864) 855-2411

Hospital & facility affiliations

  • Prisma Health Baptist Easley Hospital Hospital, Easley, SC, CCN 420015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2980SCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Practices LLC CurrentSince Jan 1, 2016 Accepting new patients
St. Francis Physician Practices LLC CurrentSince Jan 1, 2016 Accepting new patients
St Francis Physician Practices LLC Past Accepting new patients

Locations

2300 Manchester Expy
Ste A005
Columbus, GA 31904
Phone (706) 243-4550

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

Organizations & group practices 5

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 5

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": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1619367109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WHITMIRE RD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296401426",
            "telephone_number": "864-855-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WHITMIRE RD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "29640",
            "telephone_number": "864-855-2411",
            "fax_number": "864-855-2413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSEL",
        "first_name": "EMILY",
        "middle_name": "DUGGER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-04",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2980",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007499",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-AL",
            "identifier": "602-05779",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003157530A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169289",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.