Mr Liston Alexander Weatherly Jr, APRN in Hartsville, SC

Mr Liston Alexander Weatherly Jr, APRN is a medicare enrolled "Nurse Practitioner" in Hartsville, South Carolina. He graduated from nursing school in 2016 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Caresouth Carolina Inc. and his current practice location is 1268 S 4th St, Hartsville, South Carolina. You can reach out to his office (for appointments etc.) via phone at (803) 484-5317.

Mr Liston Alexander Weatherly Jr is licensed to practice in South Carolina (license number 21363) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1912413832.

Contact Information

	Mr Liston Alexander Weatherly Jr, APRN
	1268 S 4th St, Hartsville, SC 29550-0703
	(803) 484-5317
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Liston Alexander Weatherly Jr
Gender	Male
Speciality	Nurse Practitioner
Experience	8 Years
Location	1268 S 4th St, Hartsville, South Carolina
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Liston Alexander Weatherly Jr graduated from nursing school in 2016

NPI Data:

NPI Number: 1912413832
Provider Enumeration Date: 12/15/2017
Last Update Date: 09/22/2021

Medicare PECOS Information:

PECOS PAC ID: 9436411188
Enrollment ID: I20180319000505

Medical Identifiers

Medical identifiers for Mr Liston Alexander Weatherly Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912413832	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	21363 (South Carolina)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Kindred At Home	Florence, SC	Home health agency
Amedisys Home Health Of Conway	Conway, SC	Home health agency

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Caresouth Carolina Inc.	1052221314	46

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Liston Alexander Weatherly Jr allows following entities to bill medicare on his behalf.

Entity Name	Caresouth Carolina Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720082571 PECOS PAC ID: 1052221314 Enrollment ID: O20040511000280

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Liston Alexander Weatherly Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Liston Alexander Weatherly Jr, APRN Po Box 1090, Hartsville, SC 29551-1090 Ph: (843) 857-0111	Mr Liston Alexander Weatherly Jr, APRN 1268 S 4th St, Hartsville, SC 29550-0703 Ph: (803) 484-5317

Reviews and Comments

Nurse Practitioner Nurses in Hartsville, SC

Mrs. Zita Acuna Andreski, APRN FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1268 S 4th St, Hartsville, SC 29550 Phone: 843-332-3422 Fax: 843-332-3985
Ms. Gyetri Mitchell, MSN, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1304 W Bobo Newsom Hwy, Hartsville, SC 29550 Phone: 843-339-4600
Mr. Robert Alexander Campbell Jr., FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 701 Medical Park Dr Ste 207, Hartsville, SC 29550 Phone: 843-383-5191 Fax: 843-332-9229
Katelon Marie Smith, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1268 S 4th St, Hartsville, SC 29550 Phone: 843-332-3422 Fax: 843-339-5518
Staci Leigh Cassidy, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1268 S 4th St, Hartsville, SC 29550 Phone: 843-332-3422 Fax: 843-332-3985
Aquilla Bec, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1268 S 4th St, Hartsville, SC 29550 Phone: 843-332-0118
Ms. Elizabeth Anne Sorg, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1268 S 4th St, Hartsville, SC 29550 Phone: 843-332-3422 Fax: 843-332-3985

Mr Liston Alexander Weatherly Jr, APRN - Medicare Nurse Practitioner in Hartsville, SC