Individual provider Active NPI

Betina Boamah Ofori, PNP, RN

  • Pediatric Nurse Practitioner
  • Lancaster, SC
National Provider Identifier
1922414747
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
18988 Issued in SC
Practice address
834 W Meeting St Ste C
Lancaster, SC 29720-6220
Phone
(803) 313-3846
NPI assigned
Jul 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 18988 SC Primary
Registered Nurse 163W00000X 18988 SC

Addresses

Primary practice location

834 W Meeting St Ste C
Lancaster, SC 29720-6220

Mailing address

1170 Bannockburn Ave
Rock Hill, SC 29732-1095
Phone (703) 589-6186

Other practice location 1

1656 Riverchase Blvd Ste 3400
Rock Hill, SC 29732-0273
Phone (803) 328-6281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260202002373 NC Practitioner - Nurse Practitioner 6709364532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4435 Golf Acres Dr
Charlotte, NC 28208-5947

PO Box
Suite 19305
Charlotte, NC 28219

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18988SCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Dec 29, 2025 Accepting new patients
Carolinas Physicians Network, Inc CurrentSince Dec 29, 2025 Accepting new patients

Locations

10620 Park Rd
Ste 202
Charlotte, NC 28210
Phone (704) 512-3988

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1656 Riverchase Blvd
Ste 3400
Rock Hill, SC 29732
Phone (803) 328-6281

Organizations & group practices 3

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": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1922414747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 BANNOCKBURN AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321095",
            "telephone_number": "703-589-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 W MEETING ST STE C",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297206220",
            "telephone_number": "803-313-3846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1656 Riverchase Blvd Ste 3400",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297320273",
            "country_code": "US",
            "telephone_number": "803-328-6281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OFORI",
        "first_name": "BETINA",
        "middle_name": "BOAMAH",
        "credential": "PNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "18988",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "18988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, SC

Sources for this page

Verify at the official NPI Registry.