Organization · NPI-2

360 Chronic Care Management

Nurse Practitioner · Aiken, SC

NPI number1962260232

StatusActive

Last updated in NPPESJun 24, 2025

Details

NPI: 1962260232
Entity type: Organization (NPI-2)
Legal business name: 360 Chronic Care Management
Organization subpart: No
Enumeration date: Mar 11, 2024
Certification date: Jun 24, 2025
Last updated: Jun 24, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363L00000X	Nurse Practitioner	–	–	Yes
163WC0400X	Registered Nurse, Case Management	–	–
164W00000X	Licensed Practical Nurse	–	–
163WG0000X	Registered Nurse, General Practice	–	–
163WG0600X	Registered Nurse, Gerontology	–	–
163WN1003X	Registered Nurse, Nutrition Support	–	–
171400000X	Health & Wellness Coach	–	–
207QH0002X	Family Medicine, Hospice and Palliative Medicine	–	–
207RH0002X	Internal Medicine, Hospice and Palliative Medicine	–	–
225700000X	Massage Therapist	–	–
363LA2200X	Nurse Practitioner, Adult Health	–	–
363LC1500X	Nurse Practitioner, Community Health	–	–
363LG0600X	Nurse Practitioner, Gerontology	–	–
363LP2300X	Nurse Practitioner, Primary Care	–	–

Practice location

35 Varden Dr Ste A-1
Aiken, SC 29803-5275

Phone 803-243-1066 · Fax 803-226-0335

Mailing address

35 Varden Dr Ste A-1
Aiken, SC 29803-5275

Phone 803-243-1066 · Fax 803-226-0335

Other practice locations

41 W Second St
Vanceburg, KY 41179-5441

Phone 803-610-1847

3643 Walton Way Ext Bldg 4a2
Augusta, GA 30909-4507

Phone 803-610-1847

Authorized official

Juanethea Bryantlord
Business Owner
8032431066

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