NPIMap

Organization Active NPI

Kershawhealth

  • Emergency Care Clinic/Center
  • Camden, SC
National Provider Identifier
1073686994
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
KERSHAWHEALTH
Practice address
1315 Roberts St
Camden, SC 29020-3737
Phone
(803) 713-6376
NPI assigned
Nov 16, 2006
Last updated
Sep 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Authorized official

Name
Donnie J Weeks
Title
Ceo
Phone
(803) 713-6227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X SC Primary

Addresses

Primary practice location

1315 Roberts St
Camden, SC 29020-3737

Mailing address

PO Box 7003
Camden, SC 29020-7003

Other identifiers 1

IdentifierTypeStateIssuer
400480MedicaidSC

Other names 1

  • ED PHYSICIANS Other name

National Provider Directory

National Provider Directory
Tax ID family
Kershaw Health Primary Care8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1073686994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7003",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290207003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 ROBERTS ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203737",
            "telephone_number": "803-713-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERSHAWHEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "WEEKS",
        "authorized_official_first_name": "DONNIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-713-6227"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400480",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ED PHYSICIANS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Camden, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.