Individual provider Active NPI

Huyen Dung Thi Bui, NP

  • Family Nurse Practitioner
  • Sharon, SC
National Provider Identifier
1619514833
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23526 Issued in SC
Practice address
4027 Woodlawn St
Sharon, SC 29742-8779
Phone
(803) 658-5058
Fax
(803) 658-5035
NPI assigned
Dec 6, 2019
Last updated
Apr 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23526 SC Primary

Addresses

Primary practice location

4027 Woodlawn St
Sharon, SC 29742-8779

Mailing address

4027 Woodlawn St
Sharon, SC 29742-8779
Phone (803) 658-5058

Other practice location 1

1053 Center St Ste 100
West Columbia, SC 29169-6749
Phone (800) 491-0909

Other practice location 2

4724 Charlotte Hwy
Clover, SC 29710-8095
Phone (803) 831-1911

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
I20200414001312 SC Practitioner - Nurse Practitioner 3870923923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Broad River Wellness LLCGroup PAC ID 2567841281, 3 clinicians

Practice addresses (Care Compare)

4027 Woodlawn St
Sharon, SC 29742-8779
Phone (803) 658-5058

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
79.98
Improvement activities
40
Cost
79.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Broad River Wellness, LLC CurrentSince Mar 11, 2024 Accepting new patients

Locations

4027 Woodlawn St
Sharon, SC 29742
Phone (803) 627-0220

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.

NPI Registry JSON

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1619514833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4027 WOODLAWN ST",
            "city": "SHARON",
            "state": "SC",
            "postal_code": "297428779",
            "telephone_number": "803-658-5058",
            "fax_number": "803-658-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 WOODLAWN ST",
            "city": "SHARON",
            "state": "SC",
            "postal_code": "297428779",
            "telephone_number": "803-658-5058",
            "fax_number": "803-658-5035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1053 Center St Ste 100",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291696749",
            "country_code": "US",
            "telephone_number": "800-491-0909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4724 Charlotte Hwy",
            "address_purpose": "LOCATION",
            "city": "Clover",
            "state": "SC",
            "postal_code": "297108095",
            "country_code": "US",
            "telephone_number": "803-831-1911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUI",
        "first_name": "HUYEN DUNG",
        "middle_name": "THI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sharon, SC

Sources for this page

Verify at the official NPI Registry.