NPIMap

Individual provider Active NPI

Chassidy Balentine, NP

  • Gerontology Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1902440753
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
23041 Issued in SC
Practice address
890 W Faris Rd Ste 310
Greenville, SC 29605-4281
Phone
(864) 455-8300
Fax
(864) 455-8310
NPI assigned
Nov 5, 2019
Last updated
May 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 23041 SC
Gerontology Nurse Practitioner 363LG0600X 23041 SC Primary

Addresses

Primary practice location

890 W Faris Rd Ste 310
Greenville, SC 29605-4281

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200124001335 SC Practitioner - Nurse Practitioner 8022443894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

890 W Faris Rd
Suite 310
Greenville, SC 29605-4281
Phone (864) 991-9900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
23041SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Dec 9, 2019 Accepting new patients
Prisma Health University Medical Group CurrentSince Dec 9, 2019 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

890 W Faris Rd
Ste 310
Greenville, SC 29605
Phone (864) 455-8300

Interoperability endpoints

  • Direct secure messaging: cbalentine35209@direct.ghs.myhfn.org

Organizations & group practices 2

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 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1902440753",
    "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": "890 W FARIS RD STE 310",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054281",
            "telephone_number": "864-455-8300",
            "fax_number": "864-455-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALENTINE",
        "first_name": "CHASSIDY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "23041",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "23041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.