Advanced Womens Care of the Lowcountry,PC
Organization Active NPI Gynecology Physician · Bluffton, SC
NPI 1104047653 · NPPES record last updated Jan 29, 2024
Key facts
- NPI
- 1104047653
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gynecology Physician 207VG0400X
- License
- 26583 (SC)
- Legal business name
- ADVANCED WOMENS CARE OF THE LOWCOUNTRY,PC
- Practice address
- 29 Plantation Park Dr Ste 401
Bluffton, SC 29910-9006 - Phone
- (843) 341-9700
- Fax
- (843) 341-3282
- NPI assigned
- May 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Tracy A Blusewicz, M.D.
- Title
- Owner/Physician
- Phone
- (843) 341-9700
Corporate family (same tax ID) 1
Practitioners 5
-
Kristi Lynn Blessitt, M.D.
-
Jennifer Ellen Burks, CNM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070523000739 | SC | Part B Supplier - Clinic/Group Practice | 3375640402 |
Receives reassigned benefits from 2 practitioners Practice locations: Bluffton, SC |
National Provider Directory
- Tax ID family
- Advanced Womens Care of the Lowcountrypc
Locations
29 Plantation Park Dr
Ste 401
Bluffton, SC 29910
Phone (843) 341-3996
60 Main St
Unit A
Hilton Head Island, SC 29926
Phone (843) 815-5454
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician |
207VG0400X | 26583 | SC | Yes |
Addresses
Primary practice location
29 Plantation Park Dr Ste 401
Bluffton, SC 29910-9006
Mailing address
29 Plantation Park Dr Ste 401
Bluffton, SC 29910-9006
Phone (843) 341-9700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 265830 | Medicaid | SC |
Other providers in Bluffton, SC
- Kaci Adams
- Kelli Brianna Adams
- Advanced Coastal Therapy
- Advanced Healthcare Solutions
- Advanced Womens Care of the Lowcountry PC
- Adventure Pediatric Dentistry
- Affiliated Retina Consultants
- Affiliated Retina Consultants PA
- Affordable Health Care LLC
- Genesis Michelle Aguilar
All providers in Bluffton, SC · Gynecology Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.