Individual provider Active NPI

Adrienne Germond, PA-C

  • Physician Assistant
  • Columbia, SC
National Provider Identifier
1639892656
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4592 Issued in SC
Practice address
4500 8TH Division Rd
Columbia, SC 29207-5700
Phone
(803) 751-5688
NPI assigned
Sep 23, 2022
Last updated
Jun 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4592 SC Primary

Addresses

Primary practice location

4500 8TH Division Rd
Columbia, SC 29207-5700

Mailing address

4500 8TH Division Rd
Columbia, SC 29207-5700

Other practice location 1

10136 Two Notch Rd
Columbia, SC 29229-4389
Phone (803) 509-7570

Other names 1

  • Adrienne Shaw Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221117000854 SC Practitioner - Physician Assistant 7810365111 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Medcare Urgent Care Center - Anderson LLC CurrentSince Sep 19, 2022 Accepting new patients

Locations

8720 Dorchester Rd
North Charleston, SC 29420
Phone (843) 552-3629

216 Centerview Dr
Ste 100
Brentwood, TN 37027

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1639892656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 8TH DIVISION RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292075700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 8TH DIVISION RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292075700",
            "telephone_number": "803-751-5688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10136 Two Notch Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292294389",
            "country_code": "US",
            "telephone_number": "803-509-7570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GERMOND",
        "first_name": "ADRIENNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIENNE",
            "last_name": "SHAW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.