NPIMap

Organization Active NPI

Health Care Partners of South Carolina, Inc.

  • Federally Qualified Health Center (FQHC)
  • Conway, SC
National Provider Identifier
1043395346
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
20075227 Issued in SC
Legal business name
HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.
Practice address
1608 N. Main St
Conway, SC 29526-3572
Phone
(843) 248-4700
NPI assigned
Oct 26, 2006
Last updated
Dec 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Authorized official

Name
Mrs. Santina Mayo
Title
Ceo
Phone
(843) 488-6364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 20075227 SC Primary

Addresses

Primary practice location

1608 N. Main St
Conway, SC 29526-3572

Mailing address

1708 Oak St
Conway, SC 29526-3086
Phone (843) 248-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100318000064 SC Part B Supplier - Clinic/Group Practice 3577668763 Receives reassigned benefits from 38 practitioners
7 other NPIs on this enrollment
Practice locations: Conway, SC; Gresham, SC; Johnsonville, SC; Marion, SC
O20100603000598 SC Part A Provider - Federally Qualified Health Center (FQHC) 3577668763 1 other NPI on this enrollment
Practice locations: Conway, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043395346. Details of each certification follow.

Federally qualified health center certification: CCN 421810

Legal name
HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 1, 1992
Last certification
May 1, 1992
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 30, 1979 in SC
Enrollment address
1608 Main St
Conway, SC 29526-3572

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Health Care Partners Pharmacy16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

243 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 488-6030

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Melody Chriswell Individual Corporate Director Jan 1, 2009
Darrell Jameson Individual Corporate DirectorVice Chairperson Jun 1, 2015
Michael Hemingway Individual Corporate DirectorBoard Member Mar 1, 2021
Catalina Krull Individual Corporate Director Jan 1, 2009
Jeanne L Halyard Individual Corporate OfficerChief Health Officer Jan 1, 2009
Raquel Leslie-Benning Individual Corporate DirectorSecretary Apr 1, 2018
Patricia Atkinson Individual Corporate DirectorChairperson Jun 1, 2015
George Williams Individual Corporate Director Jan 1, 2009
Georgette Washington Individual Corporate DirectorBoard Member Feb 1, 2016
Robert Reel Individual Corporate OfficerChief Financial Officer Sep 1, 2019
W-2 Managing EmployeeChief Financial Officer Sep 1, 2019
Latisha McClam Individual Corporate DirectorTreasurer Apr 1, 2018
Santina Mayo Individual Corporate OfficerCeo Aug 1, 2023
Corporate DirectorCeo Aug 1, 2023
W-2 Managing EmployeeCeo Aug 1, 2023
Yvonne David Individual Corporate DirectorBoard Member Jan 3, 1997

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 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1043395346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 OAK ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263086",
            "telephone_number": "843-248-4700",
            "fax_number": "843-248-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 N. MAIN ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263572",
            "telephone_number": "843-248-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "SANTINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-488-6364",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "SC",
            "license": "20075227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.