NPIMap

Individual provider Active NPI

Stephanie Hequembourg Waldrop, MD

  • Hospitalist Physician
  • Seneca, SC
National Provider Identifier
1639465214
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
83857 Issued in SC
Practice address
298 Memorial Dr
Seneca, SC 29672-9443
Phone
(864) 885-7758
Fax
(864) 885-7749
NPI assigned
Jun 22, 2011
Last updated
May 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11016251A IN
Hospitalist Physician 208M00000X 83857 SC Primary

Addresses

Primary practice location

298 Memorial Dr
Seneca, SC 29672-9443

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

615 N Michigan St
South Bend, IN 46601-1033
Phone (574) 647-3050

Other identifiers 2

IdentifierTypeStateIssuer
838570MedicaidSC
201112570MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address swaldrop@mybeacon.cernerdirect.com
Direct Messaging Address swaldrop289780@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200706001959 SC Practitioner - Hospitalist 7315191152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

298 Memorial Dr
Seneca, SC 29672-9443
Phone (864) 482-3230

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11016251AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jun 29, 2020 Accepting new patients
Prisma Health University Medical Group Family Medicine CurrentSince Jun 29, 2020 Accepting new patients
Prisma Health-Upstate Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

Interoperability endpoints

  • Direct secure messaging: swaldrop@mybeacon.cernerdirect.com
  • Direct secure messaging: swaldrop289780@direct.ghs.myhfn.org

Organizations & group practices 3

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.

Hospital & facility affiliations 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1639465214",
    "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": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 MEMORIAL DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729443",
            "telephone_number": "864-885-7758",
            "fax_number": "864-885-7749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 N Michigan St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011033",
            "country_code": "US",
            "telephone_number": "574-647-3050",
            "fax_number": "574-647-1094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALDROP",
        "first_name": "STEPHANIE",
        "middle_name": "HEQUEMBOURG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11016251A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "83857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "838570",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201112570",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swaldrop@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "615 N Michigan St",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swaldrop289780@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "swaldrop289780@direct.ghs.myhfn.org",
            "address_1": "298 Memorial Dr",
            "city": "Seneca",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296729443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.