Jenna Viditz-Ward · Jenna M Van Bosch · Audiologist

870 Gold Hill Rd Ste 104, Fort Mill, SC 29708-8988

Overview

Jenna Viditz-Ward is a Audiologist practicing in Fort Mill, South Carolina. The National Provider Identifier (NPI) is #1093555716, which was assigned on May 30, 2024, and the registration record was last updated on December 17, 2025. The practitioner's main practice location is at 870 Gold Hill Rd Ste 104, Fort Mill, SC 29708-8988; the contact telephone number is 8036208250, and the fax number is 8036386901. The primary taxonomy of Jenna Viditz-Ward is Audiologist (231H00000X). Jenna Viditz-Ward is licensed to practice in the state of South Carolina (#7971), South Carolina (#7971).

(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.

Provider Information

NPI 1093555716
Entity Type Individual
Provider Name JENNA VIDITZ-WARD
Other Name JENNA M VAN BOSCH
(Former Name)
Gender Female
Credential AUD
Other Credential AU.D.
Practice Address 870 Gold Hill Rd Ste 104
Fort Mill
SC 29708-8988
Practice Telephone 8036208250
Practice Fax Number 8036386901
Mailing Address 870 Gold Hill Rd Ste 104
Fort Mill
SC 29708-8988
Mailing Telephone 8036208250
Mailing Fax Number 8036386901
Certification Date 2025-12-17
Enumeration Date 2024-05-30
Last Update Date 2025-12-17
Is Sole Proprietor N

Doctor and Clinician Information

PAC ID 1658811203
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name JENNA VIDITZ-WARD
Primary Specialty QUALIFIED AUDIOLOGIST
Organization Legal Name LAKESIDE AUDIOLOGY LLC
Address 870 Gold Hill Rd
Suite 104
Fort Mill
SC 29708-8988

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y231H00000XAudiologist7971SC
N237600000XAudiologist-Hearing Aid Fitter7971SC

Taxonomy Information

Primary Taxonomy

Code 231H00000X
Taxonomy Audiologist
Classification Audiologist
Grouping Speech, Language and Hearing Service Providers
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.
Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2

Other Taxonomy

Code 237600000X
Taxonomy Audiologist-Hearing Aid Fitter
Classification Audiologist-Hearing Aid Fitter
Grouping Speech, Language and Hearing Service Providers
Definition: An audiologist/hearing aid fitter is the professional who specializes in evaluating and treating people with hearing loss, conducts a wide variety of tests to determine the exact nature of an individual's hearing problem, presents a variety of treatment options to patients, dispenses and fits hearing aids, administers tests of balance to evaluate dizziness and provides hearing rehabilitation training. This classification should be used where individuals are licensed as "audiologist-hearing aid fitters" as opposed to states that license individuals as "audiologists".
Notes: Source: American Academy of Audiology, 1735 N. Lynn St, Suite 950, Arlington VA 22209, (800)AAA-2336)

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Location Information

Street Address 870 GOLD HILL RD STE 104
City FORT MILL
State SC
Zip Code 29708-8988
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Shannon Weynand 870 Gold Hill Rd Ste 104, Fort Mill, SC 29708-8988Speech-Language Pathologist2017-05-02
Kimberly L Block 870 Gold Hill Rd Ste 104, Fort Mill, SC 29708-8988Audiologist2007-04-24
Lakeside Audiology LLC 870 Gold Hill Rd Ste 104, Fort Mill, SC 29708-8988Audiologist2015-03-19
Kelly Taylor Schlicher 870 Gold Hill Rd Ste 104, Fort Mill, SC 29708-8988Audiologist2026-06-04

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Adam Nickles Palmetto Family Hearing Center, 127 Ben Casey Dr., Ste. 105, Fort Mill, SC 29708Audiologist2023-05-05
Justin Sanders 1034 Gold Hill Rd, Suite 101, Fort Mill, SC 29708Dentist2020-07-21
Laura Britney Thompson 2848 Pleasant Rd Ste 1091, Fort Mill, SC 29708Speech-Language Pathologist2018-08-09
Sabatino Vincenzo Artesi 614 Pine Links Drive, Tega Cay, SC 29708Massage Therapist2023-07-12
Home Care Partners LLC 150 Bw Thomas Dr, Suite 122, Fortmill, SC 29708In Home Supportive Care Agency2024-12-05
Modern Concepts, LLC 1808 Second Baxter Xing Ste 108, Fort Mill, SC 29708General Practice Physician2017-11-21
Henk Johannes Grobbelaar 810 Brayden Pkwy, Ste 109, Fort Mill, SC 29708General Practice Dentistry2022-06-03
Courtney Carrick 506 6th Baxter Crossing, Suite B, Fort Mill, SC 29708Assistant Behavior Analyst2021-01-07
Jennifer Marie Kasik 1670 Highway Sc-160 West, Suite 201, Fort Mill, SC 29708Chiropractor2026-04-29
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.