Musc Community Physicians

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MUSC COMMUNITY PHYSICIANS

Practice address

651A Harry C Raysor Dr
St Matthews, SC 29135-1487

Phone

(843) 792-1414

NPI assigned

Feb 7, 2023

Organization subpart

No

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

Authorized official

Name

Karyn Rae

Title

Chief, Payor Relations

Phone

(843) 876-1344

Specialties & licenses 1

Addresses

Other names 1

• MUSC Health Primary Care - St Matthews Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Rural health clinic certification: CCN 428907

Legal name

MUSC COMMUNITY PHYSICIANS

Doing business as

MUSC HEALTH PRIMARY CARE ST MATTHEWS

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Apr 1, 1997

Last certification

Oct 12, 2023

Ownership / control type

2B

Most recent change of ownership

Sep 1, 2009 (1 total)

Organization structure

CorporationNon-profit

Incorporated

Aug 1, 2021 in SC

Enrollment address

651A Harry C Raysor Dr
St Matthews, SC 29135-1487

Other NPIs with the same Medicare PAC ID 8

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

• Musc Community Physicians

  • Rural Health Clinic/Center
  • Branchville, SC
  • NPI 1043916448

  6507260668

  Same PAC ID
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772

  6507260668

  Same PAC ID
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Orangeburg, SC
  • NPI 1285330688

  6507260668

  Same PAC ID
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Holly Hill, SC
  • NPI 1508562901

  6507260668

  Same PAC ID
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Orangeburg, SC
  • NPI 1568169191

  6507260668

  Same PAC ID
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Bamberg, SC
  • NPI 1720784127

  6507260668

  Same PAC ID
• Musc Community Physicians

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006

  6507260668

  Same PAC ID
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Orangeburg, SC
  • NPI 1932805330

  6507260668

  Same PAC ID

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

CLIA laboratory certificates

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.

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1063118461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23321",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873321",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651A HARRY C RAYSOR DR",
            "city": "ST MATTHEWS",
            "state": "SC",
            "postal_code": "291351487",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSC COMMUNITY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "RAE",
        "authorized_official_first_name": "KARYN",
        "authorized_official_title_or_position": "CHIEF, PAYOR RELATIONS",
        "authorized_official_telephone_number": "843-876-1344"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MUSC Health Primary Care - St Matthews",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rural Health Clinic/Center in St Matthews, SC
• Providers in St Matthews, SC by specialty
• Rural Health Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.