Individual provider Active NPI

Erica Eaddy, MD

  • Family Medicine Physician
  • Greenwood, SC
National Provider Identifier
1659807410
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
85074 Issued in GA
Practice address
155 Academy Ave
Greenwood, SC 29646-3869
Phone
(864) 725-4865
Fax
(864) 725-4883
NPI assigned
May 11, 2017
Last updated
Aug 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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 40940 SC
Family Medicine Physician 207Q00000X 85074 GA Primary

Addresses

Primary practice location

155 Academy Ave
Greenwood, SC 29646-3869

Mailing address

PO Box 102321
Atlanta, GA 30368-2321
Phone (770) 801-2500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200626002079 GA Practitioner - Family Practice 5597010785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3355 Cascade Rd SW
Atlanta, GA 30311-3678
Phone (404) 616-7979

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as group
Quality
87.56
Promoting interoperability
100
Improvement activities
40
Cost
75.14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Jul 1, 2023 Accepting new patients
Piedmont Providers LLC Past Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

3355 Cascade Rd SW
Atlanta, GA 30311
Phone (404) 616-7979

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086

Organizations & group practices 4

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 2

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1659807410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102321",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682321",
            "telephone_number": "770-801-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463869",
            "telephone_number": "864-725-4865",
            "fax_number": "864-725-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADDY",
        "first_name": "ERICA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "40940",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "85074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.