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General NPI Number Information
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NPI Number | 1962260232
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Entity Type | Organization
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Legal Business Name | 360 CHRONIC CARE MANAGEMENT
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Dates
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Enumeration Date | 03/11/2024
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 35 VARDEN DR STE A-1
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City | AIKEN
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State | SC
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Zip | 29803-5275
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Country | US
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Telephone | 803-243-1066
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Fax | 803-226-0335
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Provider Business Mailing Address
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Address Line | 35 VARDEN DR STE A-1
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City | AIKEN
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State | SC
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Zip | 29803-5275
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Country | US
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Telephone | 803-243-1066
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Fax | 803-226-0335
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | JUANETHEA BRYANTLORD
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Credential | MVHWC
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Telephone | 803-243-1066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WG0600X
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Taxonomy Name | Gerontology Registered Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 163WN1003X
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Taxonomy Name | Nutrition Support Registered Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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