Organization Active NPI

Avenir Ventures LLC

Doing business as Amedisys Palliative Care of South Carolina

  • Community Health Nurse Practitioner
  • Beaufort, SC
National Provider Identifier
1255805693
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Nurse PractitionerTaxonomy code 363LC1500X
Legal business name
AVENIR VENTURES LLC
Doing business as
Amedisys Palliative Care of South Carolina
Practice address
2201 Boundary St Ste 112
Beaufort, SC 29902-3879
Phone
(843) 549-5166
Fax
(843) 549-5177
NPI assigned
Jan 18, 2019
Last updated
Jan 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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

Authorized official

Name
Monica Lemoine Guidroz
Title
Officer, Regulatory Reporting
Phone
(225) 292-2031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LC1500X Primary

Addresses

Primary practice location

2201 Boundary St Ste 112
Beaufort, SC 29902-3879

Mailing address

3854 American Way Ste a
Baton Rouge, LA 70816-4897
Phone (225) 292-2031

Other names 1

  • Amedisys Palliative Care of South Carolina Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121003000490 SC Part B Supplier - Clinic/Group Practice 1153593017 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beaufort, SC

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547769600000",
    "number": "1255805693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3854 AMERICAN WAY STE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164897",
            "telephone_number": "225-292-2031",
            "fax_number": "225-295-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 BOUNDARY ST STE 112",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299023879",
            "telephone_number": "843-549-5166",
            "fax_number": "843-549-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENIR VENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A",
        "authorized_official_last_name": "GUIDROZ",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "LEMOINE",
        "authorized_official_title_or_position": "OFFICER, REGULATORY REPORTING",
        "authorized_official_telephone_number": "225-292-2031"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amedisys Palliative Care of South Carolina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.