Individual provider Active NPI

Zoie Alexandra Reviere, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Johns Island, SC
National Provider Identifier
1679259204
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
27501 Issued in SC
Practice address
3227 Walter Dr Ste 1B
Johns Island, SC 29455-8171
Phone
(843) 872-5454
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 27501 SC Primary

Addresses

Primary practice location

3227 Walter Dr Ste 1B
Johns Island, SC 29455-8171

Mailing address

802 Porcari St
Charleston, SC 29412-4991
Phone (864) 529-7598

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
I20231219001564 SC Practitioner - Nurse Practitioner 8527418466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Uderitz Family Psychiatry LLCGroup PAC ID 8325313851, 7 clinicians

Practice addresses (Care Compare)

3227 Walter Dr
Suite 1B
Johns Island, SC 29455-8161
Phone (843) 872-5454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27501SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Uderitz Family Psychiatry, LLC CurrentSince Oct 16, 2023 Accepting new patients

Locations

3227 Walter Dr
Ste B
Johns Island, SC 29455
Phone (843) 572-5454

3227 Walter Dr
Ste 1B
Johns Island, SC 29455
Phone (843) 872-5454

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1679259204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 PORCARI ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294124991",
            "telephone_number": "864-529-7598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3227 WALTER DR STE 1B",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294558171",
            "telephone_number": "843-872-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVIERE",
        "first_name": "ZOIE",
        "middle_name": "ALEXANDRA",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "27501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Island, SC

Sources for this page

Verify at the official NPI Registry.