Individual provider Active NPI

Jessica Harden-Venable, D.C.

  • Chiropractor
  • Fort Mill, SC
National Provider Identifier
1922354034
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3730 Issued in SC
Practice address
3071 Highway 21 Byp
Ste 103
Fort Mill, SC 29715-7205
Phone
(704) 907-2757
NPI assigned
Jul 25, 2012
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4290 NC
Chiropractor 111N00000X 3730 SC Primary

Addresses

Primary practice location

3071 Highway 21 Byp
Ste 103
Fort Mill, SC 29715-7205

Mailing address

3071 Highway 21 Byp
Ste 103
Fort Mill, SC 29715-7205

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120906000374 SC Practitioner - Chiropractic 0042467524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3071 Hwy 21 Byp
Suite 103
Fort Mill, SC 29715-7206
Phone (803) 835-0444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4290NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Chiropractic, LLC Chiropractor CurrentSince Oct 1, 2012 Accepting new patients
Providence Chiropractic, LLC CurrentSince Oct 1, 2012 Accepting new patients

Locations

3071 Highway 21
Ste 103
Fort Mill, SC 29715
Phone (704) 907-2757

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.

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1922354034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3071 HIGHWAY 21 BYP",
            "address_2": "STE 103",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3071 HIGHWAY 21 BYP",
            "address_2": "STE 103",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157205",
            "telephone_number": "704-907-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEN-VENABLE",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4290",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.