Individual provider Active NPI

Renee Lynn Oldach, AGACNP

  • Critical Care Medicine Nurse Practitioner
  • Rock Hill, SC
National Provider Identifier
1518773191
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
SP029212 Issued in PA
Practice address
222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone
(304) 520-2415
NPI assigned
Dec 9, 2024
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X SP029212 PA Primary

Addresses

Primary practice location

222 Herlong Ave S
Rock Hill, SC 29732-1158

Mailing address

2617 Garvey Lane
Erie, PA 16506
Phone (814) 882-6606

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
I20250403000480 SC Practitioner - Nurse Practitioner 5395268072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone (803) 329-1234

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP029212PAMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hospitalist Services PC CurrentSince Mar 1, 2025 Accepting new patients

Locations

1000 Wellness Way
Fort Mill, SC 29715
Phone (803) 329-1234

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1518773191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 GARVEY LANE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "16506",
            "telephone_number": "814-882-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 HERLONG AVE S",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321158",
            "telephone_number": "304-520-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDACH",
        "first_name": "RENEE",
        "middle_name": "LYNN",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "PA",
            "license": "SP029212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.