Compassionate Care of Hartsville

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

COMPASSIONATE CARE OF HARTSVILLE

Practice address

750 W Carolina Ave
Hartsville, SC 29550-4412

Phone

(843) 951-9990

Fax

(843) 951-9989

NPI assigned

Jan 7, 2022

Organization subpart

No

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

Authorized official

Name

Kelley Marie Moody, NP-CNPI 1194358317

Title

Owner

Phone

(843) 951-9990

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Kelley Marie Moody, NP-C

  • Adult Medicine Physician
  • Hartsville, SC
  • NPI 1194358317

  SC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1063173458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W CAROLINA AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504412",
            "telephone_number": "843-951-9990",
            "fax_number": "843-951-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W CAROLINA AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504412",
            "telephone_number": "843-951-9990",
            "fax_number": "843-951-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSIONATE CARE OF HARTSVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-951-9990",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Nicole Clark, MA, MFT
• Clemson Eye, PA
• Danna Dubose Coe
• Samuel Pressly Coker III, LPC
• Community Health and Urgent Care LLC
• Gregory Stephen Connor, MD
• Dale Phillip Cooper, CACI, CACII
• Jacob S Cosby, MS, MAT
• Jenna Lane Cottingham, SLP
• Jacob Coward

• All providers in Hartsville, SC
• Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.