Individual provider Active NPI

Jenna Avins

  • Pediatric Nurse Practitioner
  • Sumter, SC
National Provider Identifier
1316747371
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
30100 Issued in SC
Practice address
370 S Pike W
Sumter, SC 29150-2664
Phone
(803) 774-4500
NPI assigned
Mar 18, 2025
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 30100 SC Primary

Addresses

Primary practice location

370 S Pike W
Sumter, SC 29150-2664

Mailing address

550 S Pike W
Sumter, SC 29150-2616
Phone (803) 774-4500

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
I20250530002277 SC Practitioner - Nurse Practitioner 8123537388 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30100SCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tandem Health SC CurrentSince May 19, 2025 Accepting new patients
Tandem Health SC CurrentSince May 19, 2025 Accepting new patients
Tandem Health SC CurrentSince May 19, 2025 Accepting new patients
Tandem Health SC Past Accepting new patients

Locations

1278 N Layfayette St
Sumter, SC 29150

370 S Pike W
Sumter, SC 29150
Phone (803) 774-6448

425 N Salem Ave
Sumter, SC 29150
Phone (803) 773-8148

550 S Pike W
Sumter, SC 29150

Interoperability endpoints

  • Direct secure messaging: jenna.avins.1@13095.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1316747371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S PIKE W",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502616",
            "telephone_number": "803-774-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 S PIKE W",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502664",
            "telephone_number": "803-774-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVINS",
        "first_name": "JENNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "30100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.