Organization Active NPI

Healthcare of the Carolinas, LLC

  • Family Medicine Physician
  • Fort Mill, SC
National Provider Identifier
1194687285
Registry record updated Dec 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HEALTHCARE OF THE CAROLINAS, LLC
Practice address
2260 Vista Rd
Fort Mill, SC 29708-7800
Phone
(839) 400-2400
NPI assigned
Nov 26, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2025

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

Authorized official

Name
Corey Wilson, MDNPI 1063859361
Title
Physician/Hospitalist
Phone
(803) 681-0158

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2260 Vista Rd
Fort Mill, SC 29708-7800

Mailing address

1750 Highway 160 W Ste 101-259
Fort Mill, SC 29708-8009
Phone (803) 681-0158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260120002910 SC Part B Supplier - Clinic/Group Practice 8921585084 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Mill, SC

National Provider Directory

National Provider Directory

Locations

1750 Highway 160 W
Ste 101259
Fort Mill, SC 29708

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1764115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766880000000",
    "number": "1194687285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 HIGHWAY 160 W STE 101-259",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088009",
            "telephone_number": "803-681-0158",
            "fax_number": "928-218-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 VISTA RD",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297087800",
            "telephone_number": "839-400-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE OF THE CAROLINAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-26",
        "last_updated": "2025-12-28",
        "certification_date": "2025-12-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "PHYSICIAN/HOSPITALIST",
        "authorized_official_telephone_number": "803-681-0158",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.