NPIMap

Organization Active NPI

Fairfield Medical Associates, LLC

  • Rural Health Clinic/Center
  • Winnsboro, SC
National Provider Identifier
1184737892
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FAIRFIELD MEDICAL ASSOCIATES, LLC
Practice address
880 West Moultrie St.
Suite 200
Winnsboro, SC 29180-1280
Phone
(803) 635-6487
Fax
(803) 635-6089
NPI assigned
Aug 16, 2006
Last updated
Aug 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Authorized official

Name
Mrs. Elizabeth A Mann
Title
Office Manager
Phone
(803) 635-6461

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X SC
Rural Health Clinic/Center 261QR1300X SC Primary

Addresses

Primary practice location

880 West Moultrie St.
Suite 200
Winnsboro, SC 29180-1280

Mailing address

PO Box 1218
Winnsboro, SC 29180-5218
Phone (803) 635-6461

Other identifiers 3

IdentifierTypeStateIssuer
RHC002MedicaidSC
423840OtherTNBLUE CROSS BLUE SHIELD
PA3996MedicaidSC

Other names 1

  • Fairfield Medical Associates, PA Former legal business name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061011000558 SC Part B Supplier - Clinic/Group Practice 3072519289 Receives reassigned benefits from 12 practitioners
Practice locations: Blythewood, SC; Winnsboro, SC
O20101110000590 SC Part A Provider - Rural Health Clinic 3072519289 Practice locations: Winnsboro, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184737892. Details of each certification follow.

Rural health clinic certification: CCN 423840

Legal name
FAIRFIELD MEDICAL ASSOCIATES, PA.
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 22, 1994
Last certification
Dec 30, 2021
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Dec 30, 1981 in SC
Enrollment address
880 West Mooltrie St
Suite 200
Winnsboro, SC 29180-2411

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0249208Fairfield Medical Associates880 West Moultrie Street Suite 200, Winnsboro, SC 29180AccreditationJan 15, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Sarah M Lewis Individual W-2 Managing Employee Sep 14, 2010
Roger Gaddy Individual 5% Or Greater Direct Ownership Interest Sep 14, 2010
Corporate Director Sep 14, 2010
Steven Barnett Individual Corporate Director Sep 14, 2010
Deborah Stuck Individual Corporate Director Sep 14, 2010
Elizabeth Mann Individual W-2 Managing Employee Sep 14, 2010
Harmon Patrick Individual 5% Or Greater Direct Ownership Interest Feb 24, 1998
Corporate Director May 1, 1999

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787616000000",
    "number": "1184737892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1218",
            "city": "WINNSBORO",
            "state": "SC",
            "postal_code": "291805218",
            "telephone_number": "803-635-6461",
            "fax_number": "803-635-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 WEST MOULTRIE ST.",
            "address_2": "SUITE 200",
            "city": "WINNSBORO",
            "state": "SC",
            "postal_code": "291801280",
            "telephone_number": "803-635-6487",
            "fax_number": "803-635-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-635-6461",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC002",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "423840",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA3996",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairfield Medical Associates, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Winnsboro, SC

Sources for this page

Verify at the official NPI Registry.