NPIMap

Organization Active NPI

Musc Community Physicians

Doing business as MUSC Health Primary Care - Bowman

  • Rural Health Clinic/Center
  • Bowman, SC
National Provider Identifier
1225735772
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MUSC COMMUNITY PHYSICIANS
Doing business as
MUSC Health Primary Care - Bowman
Practice address
106 Causeway Drive
Bowman, SC 29018-8404
Phone
(843) 792-1414
NPI assigned
Feb 14, 2023
Last updated
Feb 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Authorized official

Name
Karyn Rae
Title
Chief, Payor Relations
Phone
(843) 876-1344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

106 Causeway Drive
Bowman, SC 29018-8404

Mailing address

PO Box 23321
New York, NY 10087-4321
Phone (843) 792-6200

Other names 1

  • MUSC Health Primary Care - Bowman Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231208002919 SC Part A Provider - Rural Health Clinic 6507260668 Practice locations: Bowman, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225735772. Details of each certification follow.

Rural health clinic certification: CCN 873810

Legal name
MUSC COMMUNITY PHYSICIANS
Doing business as
MUSC HEALTH PRIMARY CARE BOWMAN
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 1, 2023
Last certification
Oct 13, 2022
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 30, 2023 in SC
Enrollment address
106 Causeway CT
Bowman, SC 29018-8404

Other NPIs with the same Medicare PAC ID 8

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

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
42D2258411Musc Health Primary Care - Bowman106 Causeway Drive, Bowman, SC 29018Certificate of waiverApr 20, 2028

National Provider Directory

National Provider Directory

Locations (25 of 48)

1520 Two Notch Rd SE
Aiken, SC 29803
Phone (803) 649-3909

3488 Main Hwy
Bamberg, SC 29003

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

2403 Allison Rd
Beaufort, SC 29902
Phone (843) 524-1078

989 Ribaut Rd
Ste 340
Beaufort, SC 29902
Phone (803) 521-8484

11 Arley Way
Ste 201B
Bluffton, SC 29910
Phone (843) 757-7700

2700 May River Xing
Bluffton, SC 29910
Phone (843) 585-2520

2700 May River Xing
Ste 100
Bluffton, SC 29910
Phone (843) 985-2520

1045 W DeKalb St
Camden, SC 29020
Phone (803) 432-8622

1111 Mill St
Camden, SC 29020
Phone (803) 425-1330

1344 Haile St
Camden, SC 29020
Phone (803) 254-3376

2034 W DeKalb St
Camden, SC 29020
Phone (803) 438-0825

2034 W DeKalb St
Unit 1512W
Camden, SC 29020

1 Science Ct
Ste 200
Columbia, SC 29203
Phone (803) 252-1913

1021 Pinnacle Point Dr
Ste 200
Columbia, SC 29223
Phone (803) 419-3830

114 Gateway Corporate Blvd
Ste 420
Columbia, SC 29203
Phone (803) 365-8650

1655 Bernardin Ave
Ste 350A
Columbia, SC 29204
Phone (866) 726-5031

2001 Laurel St
Fl 2
Columbia, SC 29204
Phone (803) 254-3278

2001 Laurel St
Ste 301
Columbia, SC 29204

2601 Laurel St
Ste 120
Columbia, SC 29204
Phone (803) 227-5320

2749 Laurel St
Columbia, SC 29204
Phone (803) 256-5774

2750 Laurel St
Ste 104
Columbia, SC 29204
Phone (803) 799-9035

2750 Laurel St
Ste 104A
Columbia, SC 29204
Phone (803) 400-5014

2750 Laurel St
Ste 104B
Columbia, SC 29204
Phone (803) 400-5014

2750 Laurel St
Ste 200A
Columbia, SC 29204

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Lisa M Goodlett Individual Corporate OfficerCfo Mar 1, 2023 100%
Sonya Floyd Individual W-2 Managing EmployeeManager Mar 1, 2023 100%
Karyn Rae Individual Corporate DirectorChief Payor Relations Mar 1, 2023 100%
Patrick J Cawley Individual Corporate OfficerCeo Mar 1, 2023 100%

Change-of-ownership history 1

DateEventCounterparty
Mar 1, 2023 Change of OwnershipThis provider was the buyer RMC Primary Care BowmanCCN 428500, SC, NPI 1922756352

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 2,288

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 2,288

NPI Registry JSON

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1225735772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23321",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100874321",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CAUSEWAY DRIVE",
            "city": "BOWMAN",
            "state": "SC",
            "postal_code": "290188404",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSC COMMUNITY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "RAE",
        "authorized_official_first_name": "KARYN",
        "authorized_official_title_or_position": "CHIEF, PAYOR RELATIONS",
        "authorized_official_telephone_number": "843-876-1344"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MUSC Health Primary Care - Bowman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowman, SC

Sources for this page

Verify at the official NPI Registry.