Active NPI
Chesterfield Clinic Corp
- Internal Medicine Physician
- Cheraw, SC
National Provider Identifier
1164454435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- CHESTERFIELD CLINIC CORP
- Practice address
- 715 S Doctors Dr
Suite B
Cheraw, SC 29520-7113 - Phone
- (843) 537-3622
- NPI assigned
- Jul 7, 2006
- Last updated
- Jul 20, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Debbie T Brewer
- Title
- Director Provider Enrollment
- Phone
- (615) 465-7626
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | SC | ||
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | Primary | ||
| Cardiovascular Disease Physician | 207RC0000X | |||
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | |||
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | |||
| Nephrology Physician | 207RN0300X | |||
| Pulmonary Disease Physician | 207RP1001X | |||
| Obstetrics & Gynecology Physician | 207V00000X | |||
| Orthopaedic Surgery Physician | 207X00000X | |||
| Pediatrics Physician | 208000000X | |||
| Surgery Physician | 208600000X |
Addresses
Primary practice location
715 S Doctors Dr
Suite B
Cheraw, SC 29520-7113
Mailing address
715 S Doctors Dr
Suite B
Cheraw, SC 29520-7113
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP4535 | Medicaid | SC | |
| GP1883 | Medicaid | SC | |
| 5950784 | Medicaid | NC | |
| 5950778 | Medicaid | NC | |
| 5900377 | Medicaid | NC |
National Provider Directory
National Provider DirectoryLocations
715 S Doctors Dr
Ste B
Cheraw, SC 29520
Phone (843) 537-3622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1311120000000",
"number": "1164454435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 S DOCTORS DR",
"address_2": "SUITE B",
"city": "CHERAW",
"state": "SC",
"postal_code": "295207113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 S DOCTORS DR",
"address_2": "SUITE B",
"city": "CHERAW",
"state": "SC",
"postal_code": "295207113",
"telephone_number": "843-537-3622"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHESTERFIELD CLINIC CORP",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-07",
"last_updated": "2011-07-20",
"status": "A",
"authorized_official_last_name": "BREWER",
"authorized_official_first_name": "DEBBIE",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "DIRECTOR PROVIDER ENROLLMENT",
"authorized_official_telephone_number": "615-465-7626"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "SC",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP4535",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP1883",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5950784",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5950778",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5900377",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cheraw, SC
- Cheraw Physicians Group LLC
- Martin Luther Sherley Cherenfant, DO
- Chesterfield Clinic Corp (Hometown Family Care)
- Chesterfield Clinic Corp (Palmetto Orthopedics Practice)
- Chesterfield Clinic Corp (Primary Care of Cheraw)
- Chesterfield Clinic Corp (Carolina Pediatrics)
- Chesterfield Clinic Corp
- Chesterfield Clinic Corp (Carolina Pediatrics)
- Chesterfield Clinic Corp
- Chesterfield Clinic Corp (Carolina Surgical Practice)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.