NPIMap

Organization Active NPI

Hedgemark Brentwood Medical Services, Inc.-Dba PHC Home Health

  • Home Health Agency
  • Charleston, SC
National Provider Identifier
1023098712
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA-084 Issued in SC
Legal business name
HEDGEMARK BRENTWOOD MEDICAL SERVICES, INC.-DBA PHC HOME HEALTH
Practice address
408 Folly Road
Charleston, SC 29412
Phone
(843) 762-3601
Fax
(843) 762-7074
NPI assigned
Jan 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Authorized official

Name
Mrs. Ellen S. Durrence, R.PH.
Title
V-President
Phone
(843) 762-3601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA-084 SC Primary

Addresses

Primary practice location

408 Folly Road
Charleston, SC 29412

Mailing address

1548 Ashley River Road Suite B
Charleston, SC 29407
Phone (843) 762-3601

Other identifiers 1

IdentifierTypeStateIssuer
470555MedicaidSC

Other names 1

  • PHC Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080716000774 SC Part A Provider - Home Health Agency 0749353266 Practice locations: Charleston, SC

Home health agency certification: CCN 427055

Legal name
HEDGEMARK BRENTWOOD MEDICAL SERVICES, INC.-DBA PHC HOME HEALTH
Doing business as
PHC HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 27, 1992
Last certification
Nov 2, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jul 26, 1984 in GA
Enrollment address
408 Folly Road
Charleston, SC 29412-2625

Care Compare: Home health agency

Medicare Care Compare
Listed as
PHC Home HealthCCN 427055
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
May 27, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

408 Folly Rd
Charleston, SC 29412
Phone (843) 762-3601

1548 Ashley River Rd
Ste B
Charleston, SC 29407

1923D Maybank Hwy
Charleston, SC 29412

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ellen Durrence Individual Corporate Director Jun 13, 2007
Hugh Dowdy Durrence Individual 5% Or Greater Direct Ownership Interest Jun 13, 2007
Corporate Director Jun 13, 2007
Laura Wood Individual W-2 Managing Employee Dec 19, 2011

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 12

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646265600000",
    "number": "1023098712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1548 ASHLEY RIVER ROAD SUITE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29407",
            "telephone_number": "843-762-3601",
            "fax_number": "843-762-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 FOLLY ROAD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29412",
            "telephone_number": "843-762-3601",
            "fax_number": "843-762-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEDGEMARK BRENTWOOD MEDICAL SERVICES, INC.-DBA PHC HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "DURRENCE",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "V-PRESIDENT",
        "authorized_official_telephone_number": "843-762-3601",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SC",
            "license": "HHA-084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470555",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHC Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHC Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.