LARENZO A CHAMPAGNE FNP-BC
NPI 1619791159
Nurse Practitioner in Charleston, SC
About Larenzo A Champagne Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LARENZO A CHAMPAGNE FNP-BC (NPI 1619791159) is an individual nurse practitioner in Charleston, South Carolina, licensed in South Carolina (29350) and active in the NPI registry since November 2024. He is enrolled in Medicare PECOS, is affiliated with Colleton Medical Center, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Larenzo A Champagne Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Larenzo Champagne reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Myrtle Beach, SC 29572
- Reassigned Medicare billing, South Carolina enrollment
- 529 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Colleton Medical Center
Acute Care Hospitals · Walterboro, SCTrident Medical Center
Acute Care Hospitals · Charleston, SCPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 29406 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
NORTH CHARLESTON, SC 29406
CHARLESTON, SC 29406
NORTH CHARLESTON, SC 29406
CHARLESTON, SC 29406
CHARLESTON, SC 29406
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 Larenzo Champagne's NPI number?
The NPI number for Larenzo Champagne is 1619791159. It was assigned to this individual provider in the NPPES registry on November 12, 2024. The provider is also known as Larenzo Antonio Champagne.
Where is Larenzo Champagne located?
Larenzo Champagne practices at 9330 Medical Plaza Dr, Charleston, SC 29406. The listed phone number is (843) 876-7080.
What is Larenzo Champagne's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Larenzo Champagne enrolled in Medicare?
Yes. Larenzo Champagne is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Larenzo Champagne's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Larenzo Champagne reassigns Medicare benefits to Southeastern Hospitalist Services PC (Myrtle Beach, 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 Larenzo Champagne's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Larenzo Champagne affiliated with any hospitals?
According to CMS data, Larenzo Champagne is affiliated with Colleton Medical Center and Trident Medical Center.
When was this NPI record last updated?
The NPPES record for Larenzo Champagne was last updated on November 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.
# Larenzo A Champagne, FNP-BC · NPI 1619791159
Nurse Practitioner physician in Charleston, South Carolina. Individual provider, active in the CMS NPPES registry since November 12, 2024.
## Identity
- **NPI:** 1619791159 (Entity type: Individual)
- **Enumerated:** November 12, 2024
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 29350 (South Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 9330 MEDICAL PLAZA DR, Charleston, SC 29406-9104
- **Phone:** (843) 876-7080
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southeastern Hospitalist Services PC (NPI 1003280108, Myrtle Beach, SC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** November 26, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1619791159) · Data from the CMS NPPES public registry.