Individual provider Active NPI

Sara Elisabeth Cothran, APRN

  • Gerontology Nurse Practitioner
  • Greenwood, SC
National Provider Identifier
1750150512
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
28229 Issued in SC
Practice address
115 Overland Dr
Greenwood, SC 29646-4053
Phone
(864) 227-6641
NPI assigned
Dec 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 28229 SC Primary

Addresses

Primary practice location

115 Overland Dr
Greenwood, SC 29646-4053

Mailing address

115 Overland Dr
Greenwood, SC 29646-4053

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
I20240213002202 SC Practitioner - Nurse Practitioner 2769825124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Medical RehabilitationGroup PAC ID 9537233762, 2 clinicians

Practice addresses (Care Compare)

1530 Pkwy
Greenwood, SC 29646-4027
Phone (864) 330-1666

Hospital & facility affiliations

  • Amedisys Home Health of Clinton Home health agency, Clinton, SC, CCN 427116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28229SCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Palmetto Medical Rehabilitation CurrentSince Mar 1, 2025 Accepting new patients
Self Medical Group Current Accepting new patients
Self Medical Group CurrentSince Jan 1, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

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

1530 Parkway
Greenwood, SC 29646
Phone (864) 330-1666

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

Organizations & group practices 4

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 1

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": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1750150512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 OVERLAND DR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464053"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTHRAN",
        "first_name": "SARA",
        "middle_name": "ELISABETH",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "28229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.