NPIMap

Organization Active NPI

Sandhills Medical Foundation, Inc.

Doing business as Sandhills Medical Foundation-Bethune

  • Federally Qualified Health Center (FQHC)
  • Bethune, SC
National Provider Identifier
1083228779
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SANDHILLS MEDICAL FOUNDATION, INC.
Doing business as
Sandhills Medical Foundation-Bethune
Practice address
103 Main Street South
Bethune, SC 29009
Phone
(866) 737-4031
NPI assigned
Sep 1, 2020
Last updated
Sep 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Ernest J WardlawNPI 1508276528
Title
Ceo
Phone
(843) 335-8291

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

103 Main Street South
Bethune, SC 29009

Mailing address

PO Box 366
MC Bee, SC 29101-0366
Phone (803) 669-3461

Other names 1

  • Sandhills Medical Foundation-Bethune Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210316001973 SC Part A Provider - Federally Qualified Health Center (FQHC) 8224949821 Practice locations: Bethune, SC
O20230104003131 SC Part B Supplier - Clinic/Group Practice 8224949821 Receives reassigned benefits from 35 practitioners
Practice locations: Bethune, SC

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1083228779. Details of each certification follow.

Federally qualified health center certification: CCN 091895

Legal name
SANDHILLS MEDICAL FOUNDATION, INC.
Doing business as
SANDHILLS MEDICAL FOUNDATION-BETHUNE
Organization structure
CorporationNon-profit
Incorporated
May 30, 1977 in SC
Enrollment address
103 Main St South
BLDG N
Bethune, SC 29009-9750

Federally qualified health center certification: CCN 871017

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SANDHILLS MEDICAL FOUNDATION-BETHUNE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 19, 2021
Last certification
Jul 19, 2021
Ownership / control type
For profit – corporation
Facility address
103 Main St South
Bethune, SC 29009

Other NPIs with the same Medicare PAC ID 9

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2194326Sandhills Medical Foundation, Inc - Bethune103 Main Street South, Bethune, SC 29009Certificate of waiverSep 29, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Paul Napper Individual Corporate DirectorInterim Ceo Oct 9, 2025
W-2 Managing EmployeeInterim Ceo Oct 9, 2025
Operational/Managerial ControlInterim Ceo Oct 9, 2025
Amanda C Duke Individual W-2 Managing EmployeeCoo Oct 9, 2025
Operational/Managerial ControlCoo Oct 9, 2025

Practitioners & affiliated clinicians

Practitioners 37

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 37

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1083228779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366",
            "city": "MC BEE",
            "state": "SC",
            "postal_code": "291010366",
            "telephone_number": "803-669-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MAIN STREET SOUTH",
            "city": "BETHUNE",
            "state": "SC",
            "postal_code": "29009",
            "telephone_number": "866-737-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDHILLS MEDICAL FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "WARDLAW",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-335-8291"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandhills Medical Foundation-Bethune",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethune, SC

Sources for this page

Verify at the official NPI Registry.