NPIMap

Organization Active NPI

Edisto Regional Health Services, Inc.

Doing business as RMC Primary Care Holly Hill

  • Rural Health Clinic/Center
  • Holly Hill, SC
National Provider Identifier
1013060953
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
EDISTO REGIONAL HEALTH SERVICES, INC.
Doing business as
RMC Primary Care Holly Hill
Practice address
187 Bunch Ford Road
Holly Hill, SC 29059-8224
Phone
(803) 496-3312
Fax
(803) 496-7713
NPI assigned
Jan 22, 2007
Last updated
Oct 23, 2015By 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 Oct 23, 2015

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

Authorized official

Name
Cheryl S Mason
Title
C.F.O.
Phone
(803) 395-2224

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

187 Bunch Ford Road
Holly Hill, SC 29059-8224

Mailing address

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

Other identifiers 7

IdentifierTypeStateIssuer
CN8991OtherSCRRMEDICARE
GP2353MedicaidSC
004OtherSCBCBS
003OtherSCTRICARE
004OtherSCBLUECHOICE
RHC012MedicaidSC
CK8831OtherSCRRMEDICARE

Other names 1

  • RMC Primary Care Holly Hill 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 2

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

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Mar 1, 2023 Change of OwnershipThis provider was the seller Musc Health Primary Care Holly HillCCN 423821, SC, NPI 1508562901

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 6

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": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445558400000",
    "number": "1013060953",
    "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": "187 BUNCH FORD ROAD",
            "city": "HOLLY HILL",
            "state": "SC",
            "postal_code": "290598224",
            "telephone_number": "803-496-3312",
            "fax_number": "803-496-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISTO REGIONAL HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDISTO REGIONAL HEALTH SERVICES, INC.",
        "enumeration_date": "2007-01-22",
        "last_updated": "2015-10-23",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "C.F.O.",
        "authorized_official_telephone_number": "803-395-2224"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "CN8991",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2353",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "004",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "003",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE",
            "identifier": "004",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC012",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "CK8831",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RMC Primary Care Holly Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holly Hill, SC

Sources for this page

Verify at the official NPI Registry.