Individual provider Active NPI

Norma June Taveras, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Summerville, SC
National Provider Identifier
1053133157
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
29585 Issued in SC
Practice address
204 N Cedar St Ste 100
Summerville, SC 29483-6453
Phone
(843) 821-2480
NPI assigned
Oct 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 29585 SC Primary

Addresses

Primary practice location

204 N Cedar St Ste 100
Summerville, SC 29483-6453

Mailing address

204 N Cedar St Ste 100
Summerville, SC 29483-6453
Phone (843) 821-2480

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
I20250107001852 SC Practitioner - Nurse Practitioner 6204364078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

204 N Cedar St
Suite 100
Summerville, SC 29483-6453
Phone (843) 821-2480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Mind Mental Health Psychiatric/Mental Health CurrentSince Dec 16, 2024 Accepting new patients

Locations

204 N Cedar St
Ste 100
Summerville, SC 29483
Phone (843) 821-2480

Organizations & group practices 1

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": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1053133157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N CEDAR ST STE 100",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836453",
            "telephone_number": "843-821-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N CEDAR ST STE 100",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836453",
            "telephone_number": "843-821-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERAS",
        "first_name": "NORMA",
        "middle_name": "JUNE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "29585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.