NPIMap

Organization Active NPI

Health Care Partners of South Carolina, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gresham, SC
National Provider Identifier
1184338592
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.
Practice address
6874 SC-908
Gresham, SC 29546
Phone
(843) 248-4700
NPI assigned
Jan 10, 2023
Last updated
May 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Authorized official

Name
Santina Mayo
Title
Ceo
Phone
(843) 488-6364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

6874 SC-908
Gresham, SC 29546

Mailing address

1608 Main St
Conway, SC 29526-3572
Phone (843) 488-6032

Other identifiers 1

IdentifierTypeStateIssuer
H8000411OtherSCFAIN

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL hcpsc.org Direct Health Care Partners of South Carolina, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100318000064 SC Part B Supplier - Clinic/Group Practice 3577668763 Receives reassigned benefits from 38 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Conway, SC; Gresham, SC; Johnsonville, SC; Marion, SC
O20230718003350 SC Part A Provider - Federally Qualified Health Center (FQHC) 3577668763 Practice locations: Gresham, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184338592. Details of each certification follow.

Federally qualified health center certification: CCN 421088

Legal name
HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 2, 2023
Last certification
Jun 2, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 7, 2023 in SC
Enrollment address
6874 SC-908
Gresham, SC 29546

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Health Care Partners of South Carolina Inc16 organizations share this tax ID, including this one
Part of
Health Care Partners of South Carolina Inc

Other organizations with this tax ID 15

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

View all 15

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Melody Chriswell Individual Corporate OfficerBoard Member Feb 1, 2007
James E Eubanks Individual Corporate OfficerCeo Jan 1, 2000
W-2 Managing EmployeeCeo Jan 1, 2000
Darrell Jameson Individual Corporate OfficerBoard Member Jun 1, 2015
Michael Hemingway Individual Corporate OfficerBoard Member Mar 1, 2021
Catalina Krull Individual Corporate OfficerBoard Member Jan 3, 2007
Raquel Leslie-Benning Individual Corporate OfficerBoard Member Apr 1, 2018
Patricia Atkinson Individual Corporate OfficerBoard Member Jun 1, 2015
George Williams Individual Corporate Officer Mar 1, 2007
Georgette Washington Individual Corporate OfficerBoard Member Feb 1, 2016
Latisha McClam Individual Corporate OfficerBoard Member Apr 1, 2018
Santina Mayo Individual Corporate OfficerCeo Aug 1, 2023
Corporate DirectorCeo Aug 1, 2023
W-2 Managing EmployeeCeo Aug 1, 2023
Yvonne David Individual Corporate OfficerBoard Member Jan 3, 1997

NPI Registry JSON

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1184338592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 MAIN ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295263572",
            "telephone_number": "843-488-6032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6874 SC-908",
            "city": "GRESHAM",
            "state": "SC",
            "postal_code": "29546",
            "telephone_number": "843-248-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH CARE PARTNERS OF SOUTH CAROLINA, INC.",
        "enumeration_date": "2023-01-10",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "SANTINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-488-6364"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAIN",
            "identifier": "H8000411",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "hcpsc.org",
            "affiliation": "Y",
            "endpointDescription": "Web site address",
            "affiliationName": "Health Care Partners of South Carolina, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6874 SC-908",
            "city": "Gresham",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gresham, SC

Sources for this page

Verify at the official NPI Registry.