NPIMap

Individual provider Active NPI

Avia Latrelle Reaves, FNP-BC

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1164076733
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23110 Issued in SC
Practice address
1301 Taylor St Ste 8a
Columbia, SC 29201
Phone
(803) 929-2955
NPI assigned
Jul 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23110 SC Primary

Addresses

Primary practice location

1301 Taylor St Ste 8a
Columbia, SC 29201

Mailing address

1301 Taylor St Ste 8a
Columbia, SC 29201-2955
Phone (803) 929-2955

Other practice location 1

5 Medical Park Road
Columbia, SC 29203
Phone (803) 434-7500

Other practice location 2

5 Medical Park Road
Columbia, SC 29203
Phone (803) 434-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200113001954 SC Practitioner - Nurse Practitioner 4284069691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

1301 Taylor St
Suite 8a
Columbia, SC 29201-2955
Phone (803) 929-2955

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Health - University of South Carolina Medical Group CurrentSince Dec 15, 2019 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 15, 2019 Accepting new patients
Prisma Health Medical Group-Midlands Current Accepting new patients

Locations

1301 Taylor St
Ste 8A
Columbia, SC 29201
Phone (803) 299-1922

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

Interoperability endpoints

  • Direct secure messaging: areaves383865@direct.ghs.myhfn.org

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1164076733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 TAYLOR ST STE 8A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012955",
            "telephone_number": "803-929-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 TAYLOR ST STE 8A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "803-929-2955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Medical Park Road",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Medical Park Road",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "29203",
            "country_code": "US",
            "telephone_number": "803-434-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REAVES",
        "first_name": "AVIA",
        "middle_name": "LATRELLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.