NPIMap

Organization Active NPI

Eventus WH Southeast - South Carolina, LLC

  • Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1790503571
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
EVENTUS WH SOUTHEAST - SOUTH CAROLINA, LLC
Practice address
2 Office Park CT Ste 103
Columbia, SC 29223-5948
Phone
(855) 743-2247
NPI assigned
Sep 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Authorized official

Name
George Hall, MDNPI 1518149277
Title
Owner
Phone
(855) 743-2247

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

2 Office Park CT Ste 103
Columbia, SC 29223-5948

Mailing address

PO Box 1431 Dept 417
Charlotte, NC 28201-1431
Phone (855) 742-2247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241216000848 SC Part B Supplier - Clinic/Group Practice 5698201523 Receives reassigned benefits from 16 practitioners
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1790503571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1431 DEPT 417",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282011431",
            "telephone_number": "855-742-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OFFICE PARK CT STE 103",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292235948",
            "telephone_number": "855-743-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVENTUS WH SOUTHEAST - SOUTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-743-2247",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.