Carolina Developmental Clinic, LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

License

23497 Issued in SC

Legal business name

CAROLINA DEVELOPMENTAL CLINIC, LLC

Practice address

107 Vista Oaks Dr Ste C
Lexington, SC 29072-8230

Phone

(803) 957-5856

Fax

(803) 957-5856

NPI assigned

Sep 17, 2010

Last updated

Sep 17, 2010By 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

Dr. Shelly Deanne Brigman, M.D.

Title

Owner and Medical Director

Phone

(803) 957-5856

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Jennifer D Tillmann, PH.D.

  • School Psychologist
  • Lexington, SC
  • NPI 1548578925
  NPD (past)

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1225346737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 VISTA OAKS DR STE C",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290728230",
            "telephone_number": "803-957-5856",
            "fax_number": "803-957-5856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 VISTA OAKS DR STE C",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290728230",
            "telephone_number": "803-957-5856",
            "fax_number": "803-957-5856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA DEVELOPMENTAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-17",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "BRIGMAN",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "DEANNE",
        "authorized_official_title_or_position": "OWNER AND MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "803-957-5856",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "SC",
            "license": "23497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234972",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Carmine
• Carolina ABA Solutions, LLC
• Carolina Behavior & Beyond LTD
• Carolina Cardiovascular Associates PA
• Carolina Counseling Associates SC, LLC
• Carolina Emergency Care
• Carolina Medical Equipment, Inc
• Carolina Nutrition Consultants Inc
• Carolina Physical Therapy and Sports Medicine, Inc.
• Carolina Reliable Home Care LLC

• Developmental Disabilities Clinic/Center in Lexington, SC
• Providers in Lexington, SC by specialty
• Developmental Disabilities Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; 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.