Caresouth South

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

CARESOUTH SOUTH

Practice address

340 Lee St
Johnston, SC 29832-1433

Phone

(803) 686-2025

Fax

(803) 275-9481

NPI assigned

Apr 27, 2017

Last updated

Apr 27, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Christie Culbreath-Dickerson

Title

Ceo

Phone

(803) 686-2025

Specialties & licenses 1

Addresses

Other names 1

• CareSouth Former legal business name

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1184159063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 LEE ST",
            "city": "JOHNSTON",
            "state": "SC",
            "postal_code": "298321433",
            "telephone_number": "803-686-2025",
            "fax_number": "803-275-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 LEE ST",
            "city": "JOHNSTON",
            "state": "SC",
            "postal_code": "298321433",
            "telephone_number": "803-686-2025",
            "fax_number": "803-275-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARESOUTH SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "CULBREATH-DICKERSON",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-686-2025",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareSouth",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Tracie Rhoden Brazell, MA-CCC-SLP
• Julia M Cockrell, RN
• Speciade Fletcher
• Dixie Gibson
• Keelie Yonce Gossett, MSP, CCC/SLP
• Jana Gruber, N.P.

• Point of Service in Johnston, SC
• Providers in Johnston, SC by specialty
• Point of Service in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.