360 Chronic Care Management
Organization Active NPI Nurse Practitioner · Aiken, SC
NPI 1962260232 · NPPES record last updated Jun 24, 2025
Key facts
- NPI
- 1962260232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- 360 CHRONIC CARE MANAGEMENT
- Practice address
- 35 Varden Dr Ste a-1
Aiken, SC 29803-5275 - Phone
- (803) 243-1066
- Fax
- (803) 226-0335
- NPI assigned
- Mar 11, 2024
- Organization subpart
- No
Authorized official
- Name
- Juanethea Bryantlord, MVHWC
- Title
- Business Owner
- Phone
- (803) 243-1066
Practitioners 6
-
Juanethea Bryantlord, NBC-HWC
-
Vivian Drenth, LPN
-
Kerri Carver, RN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240730003630 | GA | Part B Supplier - Clinic/Group Practice | 9436694031 |
Receives reassigned benefits from 1 practitioner Practice locations: Augusta, GA |
National Provider Directory
Locations
3643 Walton Way Ext
Bldg 4A2
Augusta, GA 30909
Phone (803) 610-1847
35 Varden Dr
Ste A1
Aiken, SC 29803
Phone (803) 226-0236
35 Varden Dr
#A1
Aiken, SC 29803
Phone (803) 226-0236
35 Varden Dr
Ste A
Aiken, SC 29803
Phone (803) 226-0236
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Registered Nurse |
163WC0400X | |||
| General Practice Registered Nurse |
163WG0000X | |||
| Gerontology Registered Nurse |
163WG0600X | |||
| Nutrition Support Registered Nurse |
163WN1003X | |||
| Licensed Practical Nurse |
164W00000X | |||
| Health & Wellness Coach |
171400000X | |||
| Hospice and Palliative Medicine (Family Medicine) Physician |
207QH0002X | |||
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | |||
| Massage Therapist |
225700000X | |||
| Nurse Practitioner |
363L00000X | Yes | ||
| Adult Health Nurse Practitioner |
363LA2200X | |||
| Community Health Nurse Practitioner |
363LC1500X | |||
| Gerontology Nurse Practitioner |
363LG0600X | |||
| Primary Care Nurse Practitioner |
363LP2300X |
Addresses
Primary practice location
35 Varden Dr Ste a-1
Aiken, SC 29803-5275
Mailing address
35 Varden Dr Ste a-1
Aiken, SC 29803-5275
Phone (803) 243-1066
Other practice location 1
41 W Second St
Vanceburg, KY 41179-5441
Phone (803) 610-1847
Other practice location 2
3643 Walton Way Ext Bldg 4A2
Augusta, GA 30909-4507
Phone (803) 610-1847
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PG2956 | Medicaid | SC |
Other providers in Aiken, SC
- 360 Case Management LLC
- A & P of Aiken, LLC
- Marwa Abdel Meguid
- Kristin Abram
- Accucare Medical Equipment LLC
- Accurate Prescription Services, LLC
All providers in Aiken, SC · Nurse Practitioner in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.