Active NPI
Avenir Ventures LLC
Doing business as Amedisys Palliative Care of South Carolina
- Community Health Nurse Practitioner
- Beaufort, SC
National Provider Identifier
1255805693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Nurse Practitioner
- 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, 2019
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Nurse Practitioner | 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
dba Amedisys Palliative Care
- Nurse Practitioner
- Beaufort, SC
- NPI 1518223312
O20121003000490
National Provider Directory
National Provider DirectoryMember organizations 4
Organizations listed as members of this organization in the National Provider Directory.
-
dba Amedisys Palliative Care
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Newark, DE
- NPI 1114718301
Member Of
-
dba Comfort Care Medical Group
- Physician Assistant
- Pensacola, FL
- NPI 1568723898
Member Of
-
dba Amedisys Palliative Care
- Specialist
- Somersworth, NH
- NPI 1639356751
Member Of
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.