Individual provider Active NPI

Renee B Bazzelle, RN

  • Registered Nurse
  • Charleston, SC
National Provider Identifier
1285824698
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
78789 Issued in SC
Practice address
5 Charleston Center Dr
Charleston, SC 29401-1162
Phone
(843) 958-3530
NPI assigned
Aug 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 78789 SC Primary

Addresses

Primary practice location

5 Charleston Center Dr
Charleston, SC 29401-1162

Mailing address

5 Charleston Center Dr
Charleston, SC 29401-1162

Other identifiers 1

IdentifierTypeStateIssuer
190166MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
78789SCMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1285824698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CHARLESTON CENTER DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CHARLESTON CENTER DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011162",
            "telephone_number": "843-958-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZZELLE",
        "first_name": "RENEE",
        "middle_name": "B",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "78789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190166",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.