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MS. AMANDA GRACE BEVERLY AGACNP
NPI 1902511108
Nurse Practitioner - Acute Care in Greenwood, SC

Active since January 23, 2023PECOS EnrolledAccepts Medicare Assignment
105 VINECREST CT # 1000, GREENWOOD, SC 29646(864) 725-3350(864) 725-3351 Get Directions Write a Review

NPPES record last updated: August 1, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 1, 2024, Jun 19, 2024, Jan 23, 2023 (3 updates tracked since 2023).

About Ms. Amanda Grace Beverly Agacnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. AMANDA GRACE BEVERLY AGACNP (NPI 1902511108) is an individual acute care provider in Greenwood, South Carolina, licensed in South Carolina (28004) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS, is affiliated with Self Regional Healthcare, and maintains a secondary practice location in Columbia.

NPPES Registry Identity

NPI1902511108
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameMS. AMANDA GRACE BEVERLYCredential: AGACNP
Location Address105 VINECREST CT # 1000Greenwood, SC 29646-8031
Mailing Address1601 Greene StColumbia, SC 29208-4001 · (803) 777-7412
Phone(864) 725-3350
Fax(864) 725-3351
Sole ProprietorNo
Medical School CMSUniversity Of South Carolina School Of MedicineGraduated 2023
Enumeration DateJanuary 23, 2023
Last NPPES UpdateAugust 1, 20243 updates tracked since enumeration
NPPES CertifiedAugust 1, 2024
✔ NPI 1902511108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in SC · 28004
105 VINECREST CT # 1000, Greenwood, SC 29646
Open in Google Maps ↗

Secondary Practice Location 1

Location 11601 Greene StColumbia, SC 29208-4001 · Phone (803) 777-7412

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Amanda Grace Beverly Agacnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224486600
PECOS Enrollment IDI20231122003327
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Amanda Beverly reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Self Medical Group
Same address
Pulmonary Disease
105 VINECREST CT # 1000
Greenwood, SC 29646
  • Reassigned Medicare billing, South Carolina enrollment
  • 560 clinicians in this Medicare group
NPI 1417348459 (864) 725-7491
Self Regional Healthcare
Same address
Family Medicine
105 VINECREST CT # 600
Greenwood, SC 29646
  • Reassigned Medicare billing, South Carolina enrollment
  • 231 clinicians in this Medicare group
NPI 1144012675 (864) 227-2900
University Medical Associates
154 mi
Multi-Specialty
2125 CHARLIE HALL BLVD, SUITE 100
Charleston, SC 29414
  • Reassigned Medicare billing, South Carolina enrollment
  • Medicare enrollment name: University Medical Associates Of The Medical University Of South Carol
  • 2,594 clinicians in this Medicare group
NPI 1760413835 (843) 792-1414

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Self Regional Healthcare

Acute Care Hospitals · Greenwood, SC
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420071
Location1325 Spring StreetGreenwood, SC 29646 · Greenwood County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29646 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JIMMY WANG MD
Internal Medicine (Pulmonary Disease)
105 VINECREST CT # 1000
GREENWOOD, SC 29646
Greenwood County (864) 725-3350
SELF REGIONAL HEALTHCARE
Clinic/Center (Rural Health)
105 VINECREST CT # 1000
GREENWOOD, SC 29646
Greenwood County (864) 725-3350
DR. LEONARD CHEUNG LIM M.D.
Internal Medicine (Pulmonary Disease)
105 VINECREST CT # 1000
GREENWOOD, SC 29646
Greenwood County (864) 725-3350
SELF MEDICAL GROUP
Internal Medicine (Pulmonary Disease)
105 VINECREST CT # 1000
GREENWOOD, SC 29646
Greenwood County (864) 725-7491
DR. ANNA STEPHANIE KOOKOOLIS MD
Internal Medicine (Pulmonary Disease)
105 VINECREST CT # 1000
GREENWOOD, SC 29646
Greenwood County (864) 725-3350
SELF REGIONAL HEALTHCARE
Internal Medicine (Pulmonary Disease)
105 VINECREST CT # 1000
GREENWOOD, SC 29646
Greenwood County (864) 725-3350
DR. JOHN PATRICK LIM TEJADA M.D.
Internal Medicine (Pulmonary Disease)
105 VINECREST CT # 1000
GREENWOOD, SC 29646
Greenwood County (864) 725-3350
KAYLA COTHRAN HANKS APRN, NP-C
Nurse Practitioner
105 VINECREST CT # 1000
GREENWOOD, SC 29646
Greenwood County (864) 725-3350

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amanda Beverly's NPI number?

The NPI number for Amanda Beverly is 1902511108. It was assigned to this individual provider in the NPPES registry on January 23, 2023.

Where is Amanda Beverly located?

Amanda Beverly practices at 105 Vinecrest Ct # 1000, Greenwood, SC 29646. The listed phone number is (864) 725-3350.

What is Amanda Beverly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Amanda Beverly enrolled in Medicare?

Yes. Amanda Beverly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Amanda Beverly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Beverly reassigns Medicare benefits to 3 organizations: Self Medical Group (Greenwood, SC), Self Regional Healthcare (Greenwood, SC) and University Medical Associates (Charleston, SC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Amanda Beverly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amanda Beverly accept?

Health plans from BlueCross BlueShield of South Carolina and Molina Healthcare list Amanda Beverly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Amanda Beverly affiliated with any hospitals?

According to CMS data, Amanda Beverly is affiliated with Self Regional Healthcare.

When was this NPI record last updated?

The NPPES record for Amanda Beverly was last updated on August 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.