Individual provider Active NPI

Kristi Michelle Ernandez, FNP-BC

  • Family Nurse Practitioner
  • Rock Hill, SC
National Provider Identifier
1679045017
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22011 Issued in SC
Practice address
205 Piedmont Blvd Ste 100
Rock Hill, SC 29732-1836
Phone
(803) 327-2012
NPI assigned
Dec 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22011 SC Primary

Addresses

Primary practice location

205 Piedmont Blvd Ste 100
Rock Hill, SC 29732-1836

Mailing address

448 Lakeshore Pkwy
Ste 110
Rock Hill, SC 29730-4264
Phone (803) 329-3177

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
I20200428000128 SC Practitioner - Nurse Practitioner 6002246410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Carolina Dept of Mental Health Accounting OfficeGroup PAC ID 9032021175, 226 clinicians

Practice addresses (Care Compare)

448 Lakeshore Pkwy
Suite 110
Rock Hill, SC 29730-4264
Phone (803) 329-3177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22011SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jan 12, 2020 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jan 12, 2020 Accepting new patients

Locations

524 Doctors Ct
Chester, SC 29706
Phone (803) 325-7744

448 Lakeshore Pkwy
Ste 110
Rock Hill, SC 29730
Phone (803) 323-1779

448 Lakeshore Pkwy
Ste 205
Rock Hill, SC 29730
Phone (803) 323-0007

205 Piedmont Blvd
Ste 100
Rock Hill, SC 29732
Phone (803) 323-0008

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1679045017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 LAKESHORE PKWY",
            "address_2": "STE 110",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304264",
            "telephone_number": "803-329-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PIEDMONT BLVD STE 100",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321836",
            "telephone_number": "803-327-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNANDEZ",
        "first_name": "KRISTI",
        "middle_name": "MICHELLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "22011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.