Individual provider Active NPI

Johnna Leeann Hatfield, DDS

  • Dentist
  • Greer, SC
National Provider Identifier
1669767463
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8079 Issued in SC
Practice address
301 The Pkwy
Suite B
Greer, SC 29650-5221
Phone
(864) 968-8811
Fax
(864) 968-8814
NPI assigned
Jun 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8079 SC Primary

Addresses

Primary practice location

301 The Pkwy
Suite B
Greer, SC 29650-5221

Mailing address

301 The Pkwy
Suite B
Greer, SC 29650-5221
Phone (864) 968-8811

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210913003053 SC Order and Referring Only - DentistPractitioner - Dentist 8820494057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8079SCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1669767463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 THE PKWY",
            "address_2": "SUITE B",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296505221",
            "telephone_number": "864-968-8811",
            "fax_number": "864-968-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 THE PKWY",
            "address_2": "SUITE B",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296505221",
            "telephone_number": "864-968-8811",
            "fax_number": "864-968-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATFIELD",
        "first_name": "JOHNNA",
        "middle_name": "LEEANN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-09",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "8079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.