Musc Community Physicians

Organization Active NPI Rural Health Clinic/Center · Branchville, SC

NPI 1043916448 · NPPES record last updated Feb 7, 2023

Key facts

NPI
1043916448
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
MUSC COMMUNITY PHYSICIANS
Practice address
215 Dorange Rd
Branchville, SC 29432-2241
Phone
(843) 792-1414
NPI assigned
Feb 7, 2023
Organization subpart
No

Authorized official

Name
Karyn Rae
Title
Chief, Payor Relations
Phone
(843) 876-1344

Other NPIs with the same Medicare PAC ID 8

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

Corporate family (same tax ID) 9

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

Change of ownership 1

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

Facilities with the same owner 10

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 1,353

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

View all 1,353

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0251019Musc Health Primary Care - Branchville
215 Dorange Road, Branchville, SC 29432
Certificate of waiverSep 29, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Rural health clinic certification: CCN 423856

Legal name
MUSC COMMUNITY PHYSICIANS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 1, 1995
Last certification
Oct 20, 2021
Ownership / control type
2B
Most recent change of ownership
Jan 2, 2007 (1 total)
Organization structure
Other · Non-profit
Incorporated
Aug 1, 2021 in SC
Enrollment address
215 Dorange Rd
Branchville, SC 29432-2241

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Medical University Hospital Authority
Organization · Charleston, SC
Non-profit
Operational/Managerial Control Aug 1, 2021 100%
Sonya Floyd
Individual
W-2 Managing Employee
Manager
Mar 1, 2023
Karyn Rae
Individual
Corporate Director
Chief Payor Relations and Reimbu
Mar 1, 2023 100%
Patrick J Cawley
Individual
Corporate Officer
Ceo
Jan 1, 2024 100%

Change-of-ownership history

DateEventCounterparty
Mar 1, 2023 Change of Ownership
This provider was the buyer
RMC Primary Care Branchville
CCN 423856 · SC · NPI 1487701157

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20231020002168 SC Part a Provider - Rural Health Clinic 6507260668 Practice locations: Branchville, SC

National Provider Directory

Tax ID family
Musc Community Physicians (10 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

215 Dorange Rd
Branchville, SC 29432-2241

Mailing address

PO Box 23321
New York, NY 10087-3321
Phone (843) 792-6200

Other names

  • MUSC Health Primary Care - Branchville Doing business as

Other providers in Branchville, SC

All providers in Branchville, SC · Rural Health Clinic/Center in South Carolina

Sources for this page

Verify at the official NPI Registry.