JENNA VIDITZ-WARD AUD
NPI 1093555716
Audiologist in Fort Mill, SC

Q: What is Jenna Viditz-ward's NPI number?

The NPI number for Jenna Viditz-ward is 1093555716. It was assigned to this individual provider in the NPPES registry on May 30, 2024. The provider is also known as Jenna M Van Bosch Au.D..

Q: What is Jenna Viditz-ward's specialty?

The primary specialty registered for this NPI is Audiologist with taxonomy code 231H00000X.

Q: When was this NPI record last updated?

The NPPES record for Jenna Viditz-ward was last updated on December 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 30, 2024

870 GOLD HILL RD STE 104, FORT MILL, SC 29708(803) 620-8250(803) 638-6901 Get Directions Write a Review

NPPES record last updated: December 17, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 17, 2025, Aug 16, 2024 (2 updates tracked since 2024).

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About Jenna Viditz-ward Aud NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNA VIDITZ-WARD AUD (NPI 1093555716) is an individual audiologist in Fort Mill, South Carolina, licensed in South Carolina (7971) and active in the NPI registry since May 2024. She is a graduate of Other (2024).

NPPES Registry Identity

NPI1093555716

Entity TypeIndividualFemale

Primary Taxonomy231H00000X

Provider Legal NameJENNA VIDITZ-WARDCredential: AUD

Location Address870 GOLD HILL RD STE 104Fort Mill, SC 29708-8988

Mailing Address870 Gold Hill Rd Ste 104Fort Mill, SC 29708-8988 · (803) 620-8250 · Fax (803) 638-6901

Phone(803) 620-8250

Fax(803) 638-6901

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateMay 30, 2024

Last NPPES UpdateDecember 17, 20252 updates tracked since enumeration

NPPES CertifiedDecember 17, 2025

✔ NPI 1093555716 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAudiologistSpeech, Language and Hearing Service Providers

Taxonomy Code231H00000X

License✔ Licensed in SC · 7971

Definition

(1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master's degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy.

Also ListedAudiologist-Hearing Aid FitterTaxonomy 237600000X · License 7971 (SC)

870 GOLD HILL RD STE 104, Fort Mill, SC 29708

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Other Names 1

Former Name (1)Jenna M Van Bosch Au.d.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jenna Viditz-ward Aud is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1658811203

PECOS Enrollment IDI20240910001181

Medicare Billing Reassignment

Medicare enrollment records show Jenna Viditz-ward reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lakeside Audiology LLC

Same address

Hearing and Speech

870 GOLD HILL RD STE 104
Fort Mill, SC 29708

Reassigned Medicare billing, South Carolina enrollment
3 clinicians in this Medicare group

NPI 1417341280 (803) 620-8250

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHANNON WEYNAND

Speech-Language Pathologist

870 GOLD HILL RD STE 104
FORT MILL, SC 29708

York County (803) 620-8250

DR. KELLY TAYLOR SCHLICHER AUD

Audiologist

870 GOLD HILL RD STE 104
FORT MILL, SC 29708

York County (803) 620-8250

LAKESIDE AUDIOLOGY LLC

Clinic/Center (Hearing and Speech)

870 GOLD HILL RD STE 104
FORT MILL, SC 29708

York County (803) 620-8250

DR. KIMBERLY L BLOCK AU.D.

Audiologist

870 GOLD HILL RD STE 104
FORT MILL, SC 29708

York County (803) 620-8250

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jenna Viditz-ward's NPI number?

The NPI number for Jenna Viditz-ward is 1093555716. It was assigned to this individual provider in the NPPES registry on May 30, 2024. The provider is also known as Jenna M Van Bosch Au.D..

Where is Jenna Viditz-ward located?

Jenna Viditz-ward practices at 870 Gold Hill Rd Ste 104, Fort Mill, SC 29708. The listed phone number is (803) 620-8250.

What is Jenna Viditz-ward's specialty?

The primary specialty registered for this NPI is Audiologist with taxonomy code 231H00000X.

Is Jenna Viditz-ward enrolled in Medicare?

Yes. Jenna Viditz-ward is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jenna Viditz-ward's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jenna Viditz-ward reassigns Medicare benefits to Lakeside Audiology LLC (Fort Mill, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jenna Viditz-ward's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jenna Viditz-ward accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina and Molina Healthcare list Jenna Viditz-ward as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jenna Viditz-ward was last updated on December 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.