Larenzo A Champagne, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

29350 Issued in SC

Practice address

9330 Medical Plaza Dr
Charleston, SC 29406-9104

Phone

(843) 876-7080

NPI assigned

Nov 12, 2024

Last updated

Nov 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Larenzo Antonio Champagne Other name

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

Specialty

Nurse Practitioner

Education

Other, 2024

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)

Hospital & facility affiliations

• Trident Medical Center Hospital, Charleston, SC, CCN 420079
• Colleton Medical Center Hospital, Walterboro, SC, CCN 420030

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Southeastern Hospitalist Services PC

  • Hospitalist Physician
  • Myrtle Beach, SC
  • NPI 1003280108

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD

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

• Trident Medical Center, LLC

  dba HCA Healthcare Trident Hospital

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1366496937
  Care Compare affiliation
• Walterboro Community Hospital, Inc.

  dba HCA Healthcare Colleton Hospital

  • General Acute Care Hospital
  • Walterboro, SC
  • NPI 1376597997
  Care Compare affiliation

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1619791159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 WOODGATE WAY",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294857481",
            "telephone_number": "843-860-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 MEDICAL PLAZA DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069104",
            "telephone_number": "843-876-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPAGNE",
        "first_name": "LARENZO",
        "middle_name": "A",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "29350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARENZO",
            "last_name": "CHAMPAGNE",
            "middle_name": "ANTONIO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brock Chamberlain
• Jordan Heston Chamberlin, MD
• Richard Chaz Chamberlin, MD
• Emma Chambers, OTR/L
• Yvette W Chambers
• Neena Lorenzana Champaigne, M.D.
• Meera Champaneri, RBT
• Shemika Champion, APRN
• Kam W Chan, MD
• Wai Ting Chan, PHARMD

• Nurse Practitioner in Charleston, SC
• Providers in Charleston, SC by specialty
• Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.