Active NPI
Rachel Chmunevich, FNP-C
- Family Nurse Practitioner
- Greenville, SC
National Provider Identifier
1669045100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 25162
- Practice address
- 255 Enterprise Blvd Ste 101
Greenville, SC 29615-3530 - Phone
- (864) 454-8120
- Fax
- (864) 454-8125
- NPI assigned
- Jul 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 25162 | SC | Primary |
Addresses
Primary practice location
255 Enterprise Blvd Ste 101
Greenville, SC 29615-3530
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603
Other practice location 1
208 Semillon Rd
Simpsonville, SC 29681-4794
Phone (315) 271-5939
Other practice location 2
255 Enterprise Blvd Ste 101
Greenville, SC 29615-3530
Phone (864) 454-8120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25162 | SC | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659052800000",
"number": "1669045100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE FL 4",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012842",
"telephone_number": "864-522-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 ENTERPRISE BLVD STE 101",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296153530",
"telephone_number": "864-454-8120",
"fax_number": "864-454-8125"
}
],
"practiceLocations": [
{
"address_1": "208 Semillon Rd",
"address_purpose": "LOCATION",
"city": "Simpsonville",
"state": "SC",
"postal_code": "296814794",
"country_code": "US",
"telephone_number": "315-271-5939",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "255 Enterprise Blvd Ste 101",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "SC",
"postal_code": "296153530",
"country_code": "US",
"telephone_number": "864-454-8120",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHMUNEVICH",
"first_name": "RACHEL",
"name_prefix": "Mrs.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-22",
"last_updated": "2022-07-29",
"certification_date": "2022-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "25162",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.