Individual provider Active NPI

Blair Anderson Rosemeyer, PA-C

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1821553439
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3150 Issued in SC
Practice address
1011 Frontage Rd
Greenville, SC 29615-4240
Phone
(864) 242-4263
Fax
(864) 242-2250
NPI assigned
Feb 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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 3150 SC Primary

Addresses

Primary practice location

1011 Frontage Rd
Greenville, SC 29615-4240

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6308

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
I20190320000164 SC Practitioner - Physician Assistant 3476893942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

1 Doctors Dr
Suite 100
Greenville, SC 29605-4266
Phone (864) 522-5220

1011 Frontage Rd
Greenville, SC 29615-4240
Phone (864) 242-4263

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

300 E McBee Ave
Greenville, SC 29601-2842
Phone (864) 797-6220

300 E McBee Ave FL
Suite 4
Greenville, SC 29601-2842

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3150SCMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jun 24, 2019 Accepting new patients
Prisma Health University Medical Group CurrentSince Jun 24, 2019 Accepting new patients

Locations

2000 E Greenville St
Fl 3
Anderson, SC 29621
Phone (864) 225-5131

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1011 Frontage Rd
Greenville, SC 29615
Phone (864) 242-4263

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1821553439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 FRONTAGE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154240",
            "telephone_number": "864-242-4263",
            "fax_number": "864-242-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEMEYER",
        "first_name": "BLAIR",
        "middle_name": "ANDERSON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.