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FORT MILL SENIOR WELLNESS LLC
NPI 1336992601
Nurse Practitioner in Rock Hill, SC

Active since April 08, 2024
331 E MAIN ST STE 200, ROCK HILL, SC 29730(704) 438-0687(844) 591-0104 Get Directions Write a Review

NPPES record last updated: April 8, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Fort Mill Senior Wellness Llc NPPES

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

FORT MILL SENIOR WELLNESS LLC (NPI 1336992601), doing business as Self Employed, is a healthcare organization registered as a nurse practitioner in Rock Hill, South Carolina and active in the NPI registry since April 2024. The organization lists Kelli P Gagne, President, as its authorized official.

NPPES Registry Identity

NPI1336992601
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameFORT MILL SENIOR WELLNESS LLC
Location Address331 E MAIN ST STE 200Rock Hill, SC 29730-5384
Mailing Address331 E Main St Ste 200Rock Hill, SC 29730-5384 · (860) 346-0252
Phone(704) 438-0687
Fax(844) 591-0104
Organization SubpartNo
Authorized OfficialKelli P GagnePresident · (860) 346-0252
Enumeration DateApril 8, 2024
NPPES CertifiedApril 1, 2024
✔ NPI 1336992601 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedInternal Medicine · Geriatric MedicineTaxonomy 207RG0300X
Also ListedPsychiatry & Neurology · Geriatric PsychiatryTaxonomy 2084P0805X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
331 E MAIN ST STE 200, Rock Hill, SC 29730
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Other Names 1

Former Legal Business NameSelf Employed

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

SALEM ROGERS
Behavior Technician
331 E MAIN ST STE 200
ROCK HILL, SC 29730
York County (855) 832-6727
DONNA LENAY LOVELL
Behavior Technician
331 E MAIN ST STE 200
ROCK HILL, SC 29730
York County (855) 832-6727
RELIABLE HOME HEALTHCARE LLC
In Home Supportive Care
331 E MAIN ST STE 200
ROCK HILL, SC 29730
York County (215) 303-5663
KI'ONA YAHON-DENISE MCCOY
Behavior Technician
331 E MAIN ST STE 200
ROCK HILL, SC 29730
York County (855) 832-6727
IUMA ALEXIS MARIE BECHT
Behavior Technician
331 E MAIN ST STE 200
ROCK HILL, SC 29730
York County (855) 832-6727
ELIZABETH A GUIDRY
Behavior Technician
331 E MAIN ST STE 200
ROCK HILL, SC 29730
York County (855) 832-6727
MRS. ROBYN LEIGH WORSHAM BROWN M.ED, BCBA
Behavior Analyst
331 E MAIN ST STE 200
ROCK HILL, SC 29730
York County (843) 287-0362
SC MC SPROUT LLC
Behavior Analyst
331 E MAIN ST STE 200
ROCK HILL, SC 29730
York County (833) 991-2368

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 Fort Mill Senior Wellness LLC's NPI number?

The NPI number for Fort Mill Senior Wellness LLC is 1336992601. It was assigned to this organization in the NPPES registry on April 8, 2024. The provider was formerly known as Self Employed.

Where is Fort Mill Senior Wellness LLC located?

Fort Mill Senior Wellness LLC is located at 331 E Main St Ste 200, Rock Hill, SC 29730. The listed phone number is (704) 438-0687.

What is Fort Mill Senior Wellness LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Fort Mill Senior Wellness LLC was last updated on April 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.