Individual provider Active NPI

Erin Marie Veneziano, PA-C

  • Physician Assistant
  • Little River, SC
National Provider Identifier
1770863672
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4506 Issued in SC
Practice address
3980 Highway 9 E Ste 200
Little River, SC 29566-8164
Phone
(843) 390-0100
NPI assigned
Aug 23, 2011
Last updated
Dec 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA054972 PA
Physician Assistant 363A00000X 4506 SC Primary

Addresses

Primary practice location

3980 Highway 9 E Ste 200
Little River, SC 29566-8164

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 390-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111116000525 PA Practitioner - Physician Assistant 7214101898 Reassigns benefits to 1 organization
I20221213002527 SC Practitioner - Physician Assistant 7214101898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
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)

101 McLeod Health Blvd
Suite 201
Myrtle Beach, SC 29579-4477
Phone (843) 646-8001

107 McLeod Health Blvd
Myrtle Beach, SC 29579-4477

115 McLeod Health Blvd
Myrtle Beach, SC 29579-4477

3793 McDowell LN
Little River, SC 29566-7892

3980 Hwy 9 E
Little River, SC 29566-8164

4000 Hwy 9 E
Little River, SC 29566-7833
Phone (843) 777-7000

4000 Hwy 9 W
Suite 245
Little River, SC 29566-7833
Phone (843) 366-2940

800 E Cheves St
Florence, SC 29506-2650

800 E Cheves St
Florence, SC 29506-2652

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4506SCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II CurrentSince Nov 7, 2022 Accepting new patients
University Orthopedics Center, LTD Physician Assistant CurrentSince Feb 14, 2013 Accepting new patients
University Orthopedics Center, LTD CurrentSince Feb 14, 2013 Accepting new patients
McLeod Physician Associates II CurrentSince Nov 7, 2022 Accepting new patients
McLeod Physician Associates II Past Accepting new patients

Locations

101 Regent Ct
State College, PA 16801
Phone (814) 231-1504

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

3980 Highway 9 E
Ste 200
Little River, SC 29566
Phone (843) 390-0100

Organizations & group practices 6

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.

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": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1770863672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-390-0100",
            "fax_number": "843-777-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 HIGHWAY 9 E STE 200",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295668164",
            "telephone_number": "843-390-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEZIANO",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-23",
        "last_updated": "2022-12-01",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054972",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little River, SC

Sources for this page

Verify at the official NPI Registry.