Individual provider Active NPI

Emily Elizabeth Sandlin

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1649897257
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3995 Issued in SC
Practice address
10 Patewood Dr Ste 130
Greenville, SC 29615-6317
Phone
(864) 455-8988
Fax
(864) 522-5555
NPI assigned
Jun 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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 3995 SC Primary

Addresses

Primary practice location

10 Patewood Dr Ste 130
Greenville, SC 29615-6317

Mailing address

300 E McBee Ave # F4L
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

315 West College Ave
Boiling Springs, NC 28017
Phone (704) 406-4000

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidSC

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
I20210914001471 SC Practitioner - Physician Assistant 8921404104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10 Patewood Dr
Suite 130
Greenville, SC 29615-6317
Phone (864) 522-5550

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
3995SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jul 12, 2021 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

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

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

300 E McBee Ave
#F4L
Greenville, SC 29601

1350 Cleveland St
Greenville, SC 29607
Phone (864) 271-1450

10 Patewood Dr
Ste 130
Greenville, SC 29615
Phone (864) 455-8988

Interoperability endpoints

  • Direct secure messaging: esandlin512117@direct.ghs.myhfn.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1649897257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE # F4L",
            "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": "10 PATEWOOD DR STE 130",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156317",
            "telephone_number": "864-455-8988",
            "fax_number": "864-522-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 West College Ave",
            "address_purpose": "LOCATION",
            "city": "Boiling Springs",
            "state": "NC",
            "postal_code": "28017",
            "country_code": "US",
            "telephone_number": "704-406-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDLIN",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.