Individual provider Active NPI

Elizabeth Wagoner Knight, N.P.

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1861798845
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4446 Issued in SC
Practice address
4605 Monticello Rd
Columbia, SC 29203-4156
Phone
(803) 754-0151
Fax
(803) 691-1778
NPI assigned
Feb 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4446 SC Primary

Addresses

Primary practice location

4605 Monticello Rd
Columbia, SC 29203-4156

Mailing address

4605 Monticello Rd
Columbia, SC 29203-4156
Phone (803) 754-0151

Other identifiers 1

IdentifierTypeStateIssuer
NP1791MedicaidSC

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
I20130827000382 SC Practitioner - Nurse Practitioner 5193968915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1228 Harden St
Columbia, SC 29204-1800

4605 Monticello Rd
Columbia, SC 29203-4156
Phone (803) 714-0266

4605 Monticello Rd B
Columbia, SC 29203-4156
Phone (803) 714-0266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4446SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eau Claire Cooperative Health Center, Inc. CurrentSince Jun 30, 2013 Accepting new patients
Eau Claire Cooperative Health Center ,Inc. CurrentSince Jun 30, 2013 Accepting new patients

Locations

4605 Monticello Rd
Columbia, SC 29203
Phone (803) 252-7001

4605 Monticello Rd
Bldg A
Columbia, SC 29203
Phone (803) 252-7001

3041 Old Eastover Rd
Eastover, SC 29044
Phone (803) 353-8741

Interoperability endpoints

  • Direct secure messaging: elizabeth.knight.1@10781.direct.athenahealth.com

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": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1861798845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 MONTICELLO RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292034156",
            "telephone_number": "803-754-0151",
            "fax_number": "803-691-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 MONTICELLO RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292034156",
            "telephone_number": "803-754-0151",
            "fax_number": "803-691-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "ELIZABETH",
        "middle_name": "WAGONER",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-08",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "4446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1791",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.