NPIMap

Organization Active NPI

Liberty Family Care

  • Family Medicine Physician
  • Liberty, SC
National Provider Identifier
1083663892
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIBERTY FAMILY CARE
Practice address
300 W Front St
Liberty, SC 29657-1012
Phone
(864) 843-5605
Fax
(864) 843-0996
NPI assigned
May 9, 2006
Organization subpart
Yes
Parent organization
BAPTIST EASLEY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Authorized official

Name
Mrs. Beverly B Merry
Title
Practice Administrator
Phone
(864) 843-5605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

300 W Front St
Liberty, SC 29657-1012

Mailing address

300 W Front St
Liberty, SC 29657-1012
Phone (864) 843-5605

Other identifiers 3

IdentifierTypeStateIssuer
GP5257OtherSCMEDICAID GRP-BAPTIST EASLEY -LIBERTY FAMILY CARE EFFECTIVE 10-1-2009
GP2653OtherSCMEDICAID-PHBE-LFC INEFFECTIVE 9-30-2009
1801028543OtherSCNPI-BAPTIST EASLEY-LIBERTY FAMILY CARE EFFECTIVE 10-1-2009

National Provider Directory

National Provider Directory
Tax ID family
Liberty Family Care8 organizations share this tax ID, including this one
Part of
Liberty Family Care

Other organizations with this tax ID 7

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

Locations

300 W Front St
Liberty, SC 29657
Phone (864) 843-5605

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269820800000",
    "number": "1083663892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W FRONT ST",
            "city": "LIBERTY",
            "state": "SC",
            "postal_code": "296571012",
            "telephone_number": "864-843-5605",
            "fax_number": "864-843-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W FRONT ST",
            "city": "LIBERTY",
            "state": "SC",
            "postal_code": "296571012",
            "telephone_number": "864-843-5605",
            "fax_number": "864-843-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY FAMILY CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST EASLEY HOSPITAL",
        "enumeration_date": "2006-05-09",
        "last_updated": "2010-03-29",
        "status": "A",
        "authorized_official_last_name": "MERRY",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "864-843-5605",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GRP-BAPTIST EASLEY -LIBERTY FAMILY CARE EFFECTIVE 10-1-2009",
            "identifier": "GP5257",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-PHBE-LFC INEFFECTIVE 9-30-2009",
            "identifier": "GP2653",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-BAPTIST EASLEY-LIBERTY FAMILY CARE EFFECTIVE 10-1-2009",
            "identifier": "1801028543",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; 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.