Individual provider Active NPI

Jonessa Ann Villanueva, M.D.

  • Internal Medicine Physician
  • North Myrtle Beach, SC
National Provider Identifier
1619256849
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36508 Issued in SC
Practice address
2021 N Myrtle Point Blvd Ste 101
North Myrtle Beach, SC 29582-2224
Phone
(843) 366-2900
NPI assigned
Aug 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36508 SC Primary
Internal Medicine Physician 207R00000X 2020-03573 NC

Addresses

Primary practice location

2021 N Myrtle Point Blvd Ste 101
North Myrtle Beach, SC 29582-2224

Mailing address

2021 N Myrtle Point Blvd Ste 101
North Myrtle Beach, SC 29582-2224
Phone (843) 366-2900

Other practice location 1

3350 SW 148th Ave Ste 300
Miramar, FL 33027-3259
Phone (800) 400-6354

Other identifiers 1

IdentifierTypeStateIssuer
365081MedicaidSC

Other names 1

  • Jonessa Ann Atienza Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140724002243 SC Practitioner - Internal Medicine 3173749314 Reassigns benefits to 1 organization
I20210203000402 NC Practitioner - Internal Medicine 3173749314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

2021 N Myrtle Point Blvd
Suite 104
North Myrtle Beach, SC 29582-2224
Phone (843) 366-2900

Hospital & facility affiliations

  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36508SCMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: jvillanueva92957@directmcleodehealth.org

Organizations & group practices 2

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

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": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1619256849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 N MYRTLE POINT BLVD STE 101",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822224",
            "telephone_number": "843-366-2900",
            "fax_number": "843-366-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 N MYRTLE POINT BLVD STE 101",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822224",
            "telephone_number": "843-366-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3350 SW 148th Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330273259",
            "country_code": "US",
            "telephone_number": "800-400-6354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "JONESSA ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-05",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "36508",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2020-03573",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "365081",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JONESSA ANN",
            "last_name": "ATIENZA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.