NPIMap

Organization Active NPI

Edisto Regional Health Services Inc.

Doing business as RMC Primary Care Bamberg

  • Rural Health Clinic/Center
  • Bamberg, SC
National Provider Identifier
1003130956
Registry record updated Jun 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
19072 Issued in SC
Legal business name
EDISTO REGIONAL HEALTH SERVICES INC.
Doing business as
RMC Primary Care Bamberg
Practice address
498 North Street
Bamberg, SC 29003-1377
Phone
(803) 245-5144
NPI assigned
Mar 22, 2010
Last updated
Jun 1, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
EDISTO REGIONAL HEALTH SERVICES INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Liza Porterfield
Title
C.F.O.
Phone
(803) 395-4458

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 19072 SC Primary
Family Medicine Physician 207Q00000X 19072 SC
Obstetrics & Gynecology Physician 207V00000X 22299 SC

Addresses

Primary practice location

498 North Street
Bamberg, SC 29003-1377

Mailing address

PO Box 1245
Orangeburg, SC 29116-1245
Phone (803) 395-4497

Other identifiers 7

IdentifierTypeStateIssuer
CN8991OtherSCRRMEDICARE
019OtherSCBLUECHOICE
CK8831OtherSCRRMEDICARE
GP5405MedicaidSC
019OtherSCBCBS
017OtherSCTRICARE
RHC199OtherSCMEDICARE RURAL HEALTH

Other names 1

  • RMC Primary Care Bamberg Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040810000307 SC Part B Supplier - Clinic/Group Practice 4981693447 Receives reassigned benefits from 41 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bowman, SC; Bamberg, SC; Santee, SC; Saint Matthews, SC; Orangeburg, SC; Holly Hill, SC; Branchville, SC

Other NPIs on the same Medicare enrollment 17

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 17

National Provider Directory

National Provider Directory
Part of
Low Country Pain Center

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

651A Harry C Raysor Dr
St Matthews, SC 29135
Phone (803) 395-3737

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496275200000",
    "number": "1003130956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291161245",
            "telephone_number": "803-395-4497",
            "fax_number": "803-395-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 NORTH STREET",
            "city": "BAMBERG",
            "state": "SC",
            "postal_code": "290031377",
            "telephone_number": "803-245-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISTO REGIONAL HEALTH SERVICES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDISTO REGIONAL HEALTH SERVICES INC.",
        "enumeration_date": "2010-03-22",
        "last_updated": "2017-06-01",
        "status": "A",
        "authorized_official_last_name": "PORTERFIELD",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "C.F.O.",
        "authorized_official_telephone_number": "803-395-4458",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SC",
            "license": "19072",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "19072",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "22299",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "CN8991",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE",
            "identifier": "019",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "CK8831",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5405",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "019",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "017",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RURAL HEALTH",
            "identifier": "RHC199",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RMC Primary Care Bamberg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bamberg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.