Patty R Van Wie, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2537 Issued in SC

Practice address

1247 Highway 17
Little River, SC 29566-9211

Phone

(843) 249-4092

Fax

(843) 249-1638

NPI assigned

Mar 27, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 14, 2016 through Mar 14, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coastal Cosmetic Dental Associates,

  • General Practice Dentistry
  • Little River, SC
  • NPI 1437284270
  NPD (past) Authorized official
• Dental Professionals of South Carolina, P.C.

  • General Practice Dentistry
  • Little River, SC
  • NPI 1558128058
  NPD (past)

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1972879682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295660635",
            "telephone_number": "843-249-4092",
            "fax_number": "843-249-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 HIGHWAY 17",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295669211",
            "telephone_number": "843-249-4092",
            "fax_number": "843-249-1638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WIE",
        "first_name": "PATTY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Marie Tsilionis, R.N.
• Deborah Tyler, PH.D.
• Ramnik Singh Uppal
• Usha Consulting LLC
• Pinky Subhash Vaidya, M.D.
• Marie Louise Veldhuyzen, PA-C
• Erin Marie Veneziano, PA-C
• Heather M Vincent, PA-C
• Vivatek Disc Rehab Center LLC
• Walker Urgent & Family Care, LLC

• General Practice Dentistry in Little River, SC
• Providers in Little River, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.