Uplift Dynamics LLC

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Legal business name

UPLIFT DYNAMICS LLC

Practice address

20 Designer St
Kingstree, SC 29556-5004

Phone

(843) 472-7401

NPI assigned

Jun 27, 2024

Organization subpart

No

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

Authorized official

Name

Paul FowlerNPI 1659116093

Title

Ceo

Phone

(843) 472-7401

Specialties & licenses 4

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Fowler

  • Homemaker
  • Kingstree, SC
  • NPI 1659116093
  NPD Authorized official

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1245075696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 DESIGNER ST",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295565004",
            "telephone_number": "843-472-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 DESIGNER ST",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295565004",
            "telephone_number": "843-472-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPLIFT DYNAMICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-472-7401"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olisha Chaquetta Thompson
• Kaycee Tisdale, PHARMD
• Steven Bradley Tollison, MD
• Samuel James Tomlinson III, M.D.
• Frank A Trefny, MD
• Nagasumanth Vemula, MD
• Samantha Jenkins Vereen, MASTERS
• Vital Aging of Williamsburg County, Inc.
• Frances Wadford, RN
• Donya Demesha Wallace, LPC

• Child Intellectual and/or Developmental Disabilities Respite Care in Kingstree, SC
• Providers in Kingstree, SC by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.