Individual provider Active NPI

Rontrella D Elliott

  • Social Worker
  • Ridgeville, SC
National Provider Identifier
1699011973
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
10092 Issued in SC
Practice address
331 Campbell Thickett Rd
Ridgeville, SC 29472-6339
Phone
(843) 821-3073
Fax
(843) 851-8427
NPI assigned
Dec 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 10092 SC Primary

Addresses

Primary practice location

331 Campbell Thickett Rd
Ridgeville, SC 29472-6339

Mailing address

331 Campbell Thickett Rd
Ridgeville, SC 29472-6339
Phone (843) 821-3073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1699011973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 CAMPBELL THICKETT RD",
            "city": "RIDGEVILLE",
            "state": "SC",
            "postal_code": "294726339",
            "telephone_number": "843-821-3073",
            "fax_number": "843-851-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 CAMPBELL THICKETT RD",
            "city": "RIDGEVILLE",
            "state": "SC",
            "postal_code": "294726339",
            "telephone_number": "843-821-3073",
            "fax_number": "843-851-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "RONTRELLA",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-14",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "10092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.