Individual provider Active NPI

Eryn Marie Timmons, PA-C

  • Physician Assistant
  • Greenwood, SC
National Provider Identifier
1730900317
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5580 Issued in SC
Practice address
115 Overland Dr
Greenwood, SC 29646-4053
Phone
(864) 227-6641
Fax
(864) 227-3953
NPI assigned
Oct 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5580 SC Primary

Addresses

Primary practice location

115 Overland Dr
Greenwood, SC 29646-4053

Mailing address

104 Wells Ave
Greenwood, SC 29646-3837
Phone (864) 725-4673

Other practice location 1

421 Epting Ave
Greenwood, SC 29646-4041
Phone (864) 227-6818

Other identifiers 1

IdentifierTypeStateIssuer
7569PAMedicaidSC

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
I20250212003047 SC Practitioner - Physician Assistant 7214467752 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

115 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-7272

115 Overland Dr
Greenwood, SC 29646-4053
Phone (864) 227-6641

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4095

155 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-4865

421 Epting Ave
Greenwood, SC 29646-4041
Phone (864) 227-6818

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5580SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Self Regional Healthcare CurrentSince Sep 15, 2025 Accepting new patients
Self Regional Healthcare CurrentSince Sep 15, 2025 Accepting new patients
Self Medical Group CurrentSince Oct 5, 2024 Accepting new patients
Self Medical Group CurrentSince Oct 5, 2024 Accepting new patients
Self Regional Healthcare Current Accepting new patients
Self Regional Healthcare Past Accepting new patients

Locations

75 Remittance Dr
Dept 6793
Chicago, IL 60675

75 Remittance Dr
Dept 6764
Chicago, IL 60675

905 W Greenwood St
Abbeville, SC 29620
Phone (864) 223-8090

23013 Highway 76 E
#A
Clinton, SC 29325
Phone (864) 223-8090

421 Epting Ave
Greenwood, SC 29646
Phone (864) 227-6818

115 Overland Dr
Greenwood, SC 29646
Phone (864) 227-6641

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

104 Wells Ave
Greenwood, SC 29646

207 Holiday Rd
Mc Cormick, SC 29835
Phone (800) 922-4194

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Interoperability endpoints

  • Direct secure messaging: esmith537986@selfregional.direct-ci.net

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1729123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1730900317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WELLS AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463837",
            "telephone_number": "864-725-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 OVERLAND DR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464053",
            "telephone_number": "864-227-6641",
            "fax_number": "864-227-3953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 Epting Ave",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296464041",
            "country_code": "US",
            "telephone_number": "864-227-6818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "ERYN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-17",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7569PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.