Individual provider Active NPI

Erin Copenhaver, PA-C

  • Medical Physician Assistant
  • Mt Pleasant, SC
National Provider Identifier
1992079545
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1435 Issued in SC
Practice address
1300 Hospital Dr Ste 150
Mt Pleasant, SC 29464-3243
Phone
(843) 375-2210
NPI assigned
Feb 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1435 SC
Medical Physician Assistant 363AM0700X 1435 SC Primary

Addresses

Primary practice location

1300 Hospital Dr Ste 150
Mt Pleasant, SC 29464-3243

Mailing address

82 Tradd St
Charleston, SC 29401-2534
Phone (917) 208-2776

Other practice location 1

9165 University Blvd
North Charleston, SC 29406-9120
Phone (843) 797-8162

Other identifiers 1

IdentifierTypeStateIssuer
8669OtherSC8669

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
I20170407000901 SC Practitioner - Physician Assistant 0547546467 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1435SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
National Allergy Asthma & Urticaria Centers of Charleston PA CurrentSince Dec 18, 2016 Accepting new patients

Locations

1470 Tobias Gadson Blvd
#20
Charleston, SC 29407
Phone (843) 573-9373

900 Bowman Rd
Ste 201
Mt Pleasant, SC 29464
Phone (843) 797-8162

7555 Northside Dr
North Charleston, SC 29420
Phone (843) 797-8162

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": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1992079545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 TRADD ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294012534",
            "telephone_number": "917-208-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HOSPITAL DR STE 150",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643243",
            "telephone_number": "843-375-2210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9165 University Blvd",
            "address_purpose": "LOCATION",
            "city": "North Charleston",
            "state": "SC",
            "postal_code": "294069120",
            "country_code": "US",
            "telephone_number": "843-797-8162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPENHAVER",
        "first_name": "ERIN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1435",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "8669",
            "identifier": "8669",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

Verify at the official NPI Registry.