NPIMap

Individual provider Active NPI

Andrill Lavour Richard, FNP

  • Nurse Practitioner
  • Greenwood, SC
National Provider Identifier
1982241956
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23399 Issued in SC
Practice address
115 Academy Avenue
Greenwood, SC 29646
NPI assigned
Dec 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23399 SC
Nurse Practitioner 363L00000X 23399 SC Primary

Addresses

Primary practice location

115 Academy Avenue
Greenwood, SC 29646

Mailing address

1198 Leaman St
Cross Hill, SC 29332-4100
Phone (864) 993-6320

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
I20200121001677 SC Practitioner - Nurse Practitioner 6204261258 Reassigns benefits to 2 organizations

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
Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

155 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-4865

160 Academy Ave
Greenwood, SC 29646-3808
Phone (864) 223-8090

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23399SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group CurrentSince Dec 9, 2019 Accepting new patients
Self Regional Healthcare CurrentSince Feb 2, 2026 Accepting new patients
Self Medical Group CurrentSince Dec 9, 2019 Accepting new patients
Self Medical Group Current Accepting new patients
Self Regional Healthcare CurrentSince Feb 2, 2026 Accepting new patients
Self Regional Healthcare Past Accepting new patients

Locations

75 Remittance Dr
Dept 6793
Chicago, IL 60675

75 Remittance Dr
Dept 6764
Chicago, IL 60675

115 Academy Ave
Greenwood, SC 29646
Phone (864) 725-7272

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

22580 Highway 76 E
Ste 200
Laurens, SC 29360
Phone (864) 725-1480

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1982241956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1198 LEAMAN ST",
            "city": "CROSS HILL",
            "state": "SC",
            "postal_code": "293324100",
            "telephone_number": "864-993-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ACADEMY AVENUE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "ANDRILL",
        "middle_name": "LAVOUR",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23399",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "23399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.