Elizabeth Ann Ball
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Charleston, SC
NPI 1992748875 · NPPES record last updated Mar 1, 2017
Key facts
- NPI
- 1992748875
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 4401 (SC)
- Practice address
- 2100 Charlie Hall Blvd
Charleston, SC 29414-5832 - Phone
- (843) 852-4100
- Fax
- (843) 573-2393
- NPI assigned
- Jun 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170203001957 | SC | Practitioner - Nurse Practitioner | 1658376058 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4401 | SC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St James Health and Wellness Inc | Current | Accepting new patients | |
| St James Health and Wellness Inc | Current |
Accepting new patients | |
| St. James Health and Wellness Inc. | Current |
Accepting new patients |
Locations
1189 Tibwin Rd
Mc Clellanville, SC 29458
Phone (843) 887-3929
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 4401 | SC | Yes |
Addresses
Primary practice location
2100 Charlie Hall Blvd
Charleston, SC 29414-5832
Mailing address
2100 Charlie Hall Blvd
Charleston, SC 29414-5832
Phone (843) 852-4100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4401 | Medicaid | SC |
Other providers in Charleston, SC
- Chelsey Kayla Baldwin Teschner
- Lindsay Baldwin
- Ruth M Baldwin
- Stephen Joseph Balevic
- Prabhakar Baliga
- James Ball
- Kristen Allen Ball
- Samantha Lynn Ball
- Victoria J Ball
- Priyanka Ballal
All providers in Charleston, SC · Psychiatric/Mental Health Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.