NPIMap

Organization Active NPI

Lower Florence County Hospital

Doing business as Pee Dee Family Practice Johnsonville

  • Family Medicine Physician
  • Johnsonville, SC
National Provider Identifier
1083815799
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
GP2834 Issued in SC
Legal business name
LOWER FLORENCE COUNTY HOSPITAL
Doing business as
Pee Dee Family Practice Johnsonville
Practice address
625 S Georgetown Hwy
Johnsonville, SC 29555
Phone
(843) 386-2350
Fax
(843) 386-3791
NPI assigned
May 30, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Mary C Duke
Title
Director of PFS
Phone
(843) 374-6431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X GP2834 SC Primary

Addresses

Primary practice location

625 S Georgetown Hwy
Johnsonville, SC 29555

Mailing address

258 N Ron McNair Blvd
Lake City, SC 29560-2462
Phone (843) 374-2036

Other identifiers 1

IdentifierTypeStateIssuer
GP2834MedicaidSC

Other names 1

  • PEE DEE FAMILY PRACTICE JOHNSONVILLE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lower Florence County Hosp7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083815799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 N RON MCNAIR BLVD",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602462",
            "telephone_number": "843-374-2036",
            "fax_number": "843-374-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S GEORGETOWN HWY",
            "city": "JOHNSONVILLE",
            "state": "SC",
            "postal_code": "29555",
            "telephone_number": "843-386-2350",
            "fax_number": "843-386-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER FLORENCE COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF PFS",
        "authorized_official_telephone_number": "843-374-6431",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "GP2834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2834",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEE DEE FAMILY PRACTICE JOHNSONVILLE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.