Individual provider Active NPI

Amanda Ellenburg Chapman, NP

  • Family Nurse Practitioner
  • Greenwood, SC
National Provider Identifier
1679165419
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24642 Issued in SC
Practice address
201 Lakewood Dr
Greenwood, SC 29649-9181
Phone
(864) 389-1444
NPI assigned
Feb 3, 2021
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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 24642 SC Primary

Addresses

Primary practice location

201 Lakewood Dr
Greenwood, SC 29649-9181

Mailing address

201 Lakewood Dr
Greenwood, SC 29649-9181
Phone (864) 389-1444

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
I20210617003058 SC Practitioner - Nurse Practitioner 6800296443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Providers of America LLCGroup PAC ID 9931529948, 97 clinicians

Practice addresses (Care Compare)

20 Hawthorne Park CT
Greenville, SC 29615-3194
Phone (864) 535-5381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health Providers of America, LLC CurrentSince Apr 2, 2022 Accepting new patients

Locations

20 Hawthorne Park Ct
Greenville, SC 29615
Phone (864) 288-6775

1408 Parkway
Greenwood, SC 29646
Phone (864) 223-2281

110 Summit Hills Dr
Spartanburg, SC 29307
Phone (864) 428-8051

Organizations & group practices 1

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": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1679165419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LAKEWOOD DR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296499181",
            "telephone_number": "864-389-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LAKEWOOD DR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296499181",
            "telephone_number": "864-389-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN",
        "first_name": "AMANDA",
        "middle_name": "ELLENBURG",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.