Individual provider Active NPI

Violetta Czepowicz, M.D.

  • Psychiatry Physician
  • Greenville, SC
National Provider Identifier
1356325435
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
16304 Issued in SC
Practice address
701 Grove Rd FL 1
Greenville, SC 29605-4210
Phone
(864) 422-7899
NPI assigned
Dec 2, 2005
Last updated
Jan 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 16304 SC Primary

Addresses

Primary practice location

701 Grove Rd FL 1
Greenville, SC 29605-4210

Mailing address

PO Box 2585
Columbus, GA 31902-2585
Phone (706) 660-8505

Other practice location 1

152 Waccamaw Medical Park Dr
Conway, SC 29526-8901
Phone (843) 347-8871

Other identifiers 1

IdentifierTypeStateIssuer
163049MedicaidSC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031229000172 SC Practitioner - PsychiatryPractitioner - Addiction Medicine 1254239338 Reassigns benefits to 2 organizations
Practice locations: Conway, SC

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

164 Waccamaw Medical Park Dr
Conway, SC 29526-8903
Phone (843) 347-5060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16304SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jun 5, 2018 Accepting new patients
HHC South Carolina Inc CurrentSince Apr 28, 2022 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jun 5, 2018 Accepting new patients
Lower Cape Fear Hospice, Incorporated Past Accepting new patients

Locations

2100 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 212-8968

701 E Bay St
#1110
Charleston, SC 29403
Phone (843) 727-2000

2414 Bull St
#3183
Columbia, SC 29201

152 Waccamaw Medical Park Dr
Conway, SC 29526
Phone (843) 347-8871

164 Waccamaw Medical Park Dr
Conway, SC 29526
Phone (843) 347-4888

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1356325435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2585",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319022585",
            "telephone_number": "706-660-8505",
            "fax_number": "706-660-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD FL 1",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-422-7899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "152 Waccamaw Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295268901",
            "country_code": "US",
            "telephone_number": "843-347-8871",
            "fax_number": "843-234-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CZEPOWICZ",
        "first_name": "VIOLETTA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-02",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "16304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163049",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.