Active NPI
Sentinel Health Partners, PA
- Clinical Medical Laboratory
- Camden, SC
National Provider Identifier
1184989840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 42D0248605
- Legal business name
- SENTINEL HEALTH PARTNERS, PA
- Practice address
- 1344 Haile St
Camden, SC 29020-3076 - Phone
- (803) 432-1996
- NPI assigned
- Jul 9, 2012
- Organization subpart
- Yes
- Parent organization
- SENTINEL HEATH PARTNERS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kim Bray
- Title
- Director, I.T.
- Phone
- (803) 713-8350
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 42D0248605 | SC | Primary |
Addresses
Primary practice location
1344 Haile St
Camden, SC 29020-3076
Mailing address
PO Box 1259
Camden, SC 29021-1259
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002 | Other | BCBS OF SC | |
| GP1679 | Medicaid | SC | |
| 0001 | Other | SC | PTAN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D0248605 | Musc Health Primary Care Haile Street | Provider-performed microscopy | Jun 23, 2028 |
National Provider Directory
National Provider Directory- Part of
- Sentinel Health Partner
Locations
2689 Highway 1 S
Elgin, SC 29045
Phone (803) 438-7698
1165 Highway 1 S
Ste 400
Lugoff, SC 29078
Phone (803) 408-3262
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341792000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1399852800000",
"number": "1184989840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1259",
"city": "CAMDEN",
"state": "SC",
"postal_code": "290211259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1344 HAILE ST",
"city": "CAMDEN",
"state": "SC",
"postal_code": "290203076",
"telephone_number": "803-432-1996"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENTINEL HEALTH PARTNERS, PA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SENTINEL HEATH PARTNERS",
"enumeration_date": "2012-07-09",
"last_updated": "2014-05-12",
"status": "A",
"authorized_official_last_name": "BRAY",
"authorized_official_first_name": "KIM",
"authorized_official_title_or_position": "DIRECTOR, I.T.",
"authorized_official_telephone_number": "803-713-8350"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "SC",
"license": "42D0248605",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF SC",
"identifier": "002",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP1679",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "0001",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Camden, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.