Andrea B Trader, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1513 Issued in SC

Practice address

206 Swift Creek Rd
Hartsville, SC 29550-4383

Phone

(843) 383-5191

Fax

(843) 383-8895

NPI assigned

Jul 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Black Creek Medical Consultants LLCGroup PAC ID 9335455914, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051
• Carolina Pines Regional Medical Center Hospital, Hartsville, SC, CCN 420010

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8689/brand/1/csg/1/fhir/r4

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.

• Black Creek Medical Consultants, LLC

  • Sleep Medicine (Otolaryngology) Physician
  • Hartsville, SC
  • NPI 1245623792
  Medicare reassignment Care Compare group NPD
• Hartsville Medical Group LLC

  • Internal Medicine Physician
  • Hartsville, SC
  • NPI 1598995300
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hartsville, LLC

  • General Acute Care Hospital
  • Hartsville, SC
  • NPI 1174500458
  Care Compare affiliation
• McLeod Regional Medical Center of the Pee Dee, Inc.

  • General Acute Care Hospital
  • Florence, SC
  • NPI 1699756221
  Care Compare affiliation

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1942239736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MEDICAL PARK DR",
            "address_2": "STE 300",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504777",
            "telephone_number": "843-383-5191",
            "fax_number": "843-383-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 SWIFT CREEK RD",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504383",
            "telephone_number": "843-383-5191",
            "fax_number": "843-383-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRADER",
        "first_name": "ANDREA",
        "middle_name": "B",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "1513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Theobald, PT
• Therapeutic Designs and Services
• Shaniqua Sharda Timmons
• Tony Skorput PA
• Total Renal Care Inc
• Trent Hill Center for Children and Families
• Crystal Tuck, MS, LPC
• Howard Webster Tucker Jr., O.D.
• Cordia Chassidy Varney
• Visac LLC

• Family Nurse Practitioner in Hartsville, SC
• Providers in Hartsville, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.