Trina Nicole Ravenell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2783 Issued in SC

Practice address

200 Patewood Dr Ste B400
Greenville, SC 29615-6306

Phone

(864) 454-4368

Fax

(864) 241-9232

NPI assigned

Jul 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Emory University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Spartanburg Medical Center

  • Emergency Medicine Physician
  • Spartanburg, SC
  • NPI 1699729939
  Medicare reassignment Care Compare group
• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment
• Prisma Health University Medical Group

  • Family Medicine Physician
  • Easley, SC
  • NPI 1295218642
  NPD
• Spartanburg Medical Center

  • Internal Medicine Physician
  • Spartanburg, SC
  • NPI 1801206123
  NPD
• Spartanburg Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1942188875
  NPD
• Spartanburg Medical Center

  • Obstetrics & Gynecology Physician
  • Spartanburg, SC
  • NPI 1376580852
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Spartanburg Medical Center

  • Psychiatric Hospital Unit
  • Spartanburg, SC
  • NPI 1033681630
  Care Compare affiliation
• Spartanburg Medical Center

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1326373697

  Hospital

  Care Compare affiliation
• Spartanburg Medical Center

  • General Acute Care Hospital
  • Spartanburg, SC
  • NPI 1609807122
  Care Compare affiliation
• Spartanburg Medical Center

  • Rehabilitation Hospital Unit
  • Spartanburg, SC
  • NPI 1942772546
  Care Compare affiliation

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1629590583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE B400",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156306",
            "telephone_number": "864-454-4368",
            "fax_number": "864-241-9232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Verdae Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296074032",
            "country_code": "US",
            "telephone_number": "864-242-4683",
            "fax_number": "864-240-8104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVENELL",
        "first_name": "TRINA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "TL2783",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2783",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "MPA2783TL",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC BOARD OF MEDICAL EXAMINERS",
            "identifier": "MPA2783TL",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3026PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SCA853",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "travenell171048@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "travenell171048@direct.ghs.myhfn.org",
            "address_1": "1025 Verdae Blvd Ste A",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296074032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Haseeb Ali Rauf, DMD
• Robert Austin Raunikar, M.D.
• Ravenel Endodontics
• Ravenel Periodontics, PA
• Lisa S Ravenel, DMD, MHS
• Amy Ruth Ravenscraft, NP
• Pinjai Ramadas Ravichander, M.D.
• Senthuran Ravindran, M.D.
• Benjamin Ellis Rawls, M.D.
• Taylor Elgin Rawls, FNP

• Physician Assistant in Greenville, SC
• Providers in Greenville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.