Individual provider Active NPI

Erik Dennis Cantrell, MD

  • Psychiatry Physician
  • Charleston, SC
National Provider Identifier
1750519948
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
39101 Issued in SC
Practice address
2079 Charlie Hall Blvd
Charleston, SC 29414-5834
Phone
(843) 843-5622
NPI assigned
Jun 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X BP10042130 TX
Psychiatry Physician 2084P0800X 39101 SC Primary

Addresses

Primary practice location

2079 Charlie Hall Blvd
Charleston, SC 29414-5834

Mailing address

2079 Charlie Hall Blvd
Charleston, SC 29414-5834
Phone (843) 974-5622

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address provider@centerway.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160428000069 SC Practitioner - Psychiatry 1557660487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Texas Tech University Health Science Center School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centerway Behavioral Health LLCGroup PAC ID 4981943818, 4 clinicians

Practice addresses (Care Compare)

2287 Henry Tecklenburg Dr
Suite 2
Charleston, SC 29414-7801
Phone (843) 974-5622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10042130TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerway Behavioral Health LLC Psychiatry CurrentSince Jan 30, 2017 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Psychiatry Past Accepting new patients

Locations

2079 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 554-8488

2287 Henry Tecklenburg Dr
Ste 2
Charleston, SC 29414
Phone (843) 974-5622

Organizations & group practices 2

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1750519948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2079 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145834",
            "telephone_number": "843-974-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2079 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145834",
            "telephone_number": "843-843-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "ERIK",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "BP10042130",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "39101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "provider@centerway.com",
            "affiliation": "N",
            "endpointDescription": "Secure email",
            "address_1": "2079 Charlie Hall Blvd",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294145834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.