Active NPI
Ccmma SC LLC
- Critical Care Medicine (Internal Medicine) Physician
- Sumter, SC
National Provider Identifier
1245715796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- Legal business name
- CCMMA SC LLC
- Practice address
- 129 N Washington St
Sumter, SC 29150-4949 - Phone
- (803) 774-9000
- NPI assigned
- Oct 1, 2018
- Last updated
- Apr 28, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Corey Scurlock, MD
- Title
- Member
- Phone
- (914) 523-2189
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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | |||
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | Primary | ||
| Pulmonary Disease Physician | 207RP1001X |
Addresses
Primary practice location
129 N Washington St
Sumter, SC 29150-4949
Mailing address
PO Box 631797
Cincinnati, OH 45263-1797
Phone (845) 702-2711
Other practice location 1
120 N Delaware St
Sandusky, MI 48471-1009
Phone (810) 648-3770
Other practice location 2
350 Boulevard
Passaic, NJ 07055-2840
Phone (973) 365-4300
Other practice location 3
425 W 5th St
East Liverpool, OH 43920-2405
Phone (330) 385-7200
Other practice location 4
5315 E Larkspur Dr
Scottsdale, AZ 85254-4227
Phone (845) 702-2711
Other practice location 5
1015 Priory Pl
Mc Lean, VA 22101-2134
Phone (845) 702-2711
Other practice location 6
120 Leeuwarden Rd
Darien, CT 06820-3027
Phone (845) 702-2711
Other practice location 7
625 Gore Range Dr
Severance, CO 80550-4869
Phone (845) 702-2711
Other practice location 8
27 Henderson St
Arlington, MA 02474-5507
Phone (845) 702-2711
Other practice location 9
5605 Poola St
Honolulu, HI 96821-1564
Phone (845) 702-2711
Other practice location 10
386 Acadian Ct
Biloxi, MS 39531-2900
Phone (845) 702-2711
Other practice location 11
1481 Hollis Rdg
Clarksville, TN 37043-1522
Phone (845) 702-2711
Other practice location 12
201 NW R D Mize Rd
Blue Springs, MO 64014-2513
Phone (816) 228-5900
Other practice location 13
425 W 5th St
East Liverpool, OH 43920-2498
Phone (330) 385-7200
Other practice location 14
600 S Monroe St
Enid, OK 73701-7211
Phone (580) 233-2300
Other practice location 15
59-351 Lehiwa Pl
Kamuela, HI 96743-8581
Phone (845) 702-2711
Other practice location 16
10 Nadia S Way
Farmington, CT 06032-2860
Phone (845) 702-2711
Other practice location 17
6565 Fannin St
Houston, TX 77030-2703
Phone (713) 790-3311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, OH, MS, HI, CT, DC, MA, CO, AZ, TN, VA, OR, IN, NM, AL, IA, GA, NV, WA, KS, WI
Enrollment records 21
National Provider Directory
National Provider DirectoryLocations
15125 N Scottsdale Rd
Scottsdale, AZ 85254
1771 N Pierce St
Arlington, VA 22209
Practitioners & affiliated clinicians
Practitioners 69
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.
-
- Critical Care Medicine (Internal Medicine) Physician
- Concord, MA
- NPI 1568625820
AZ
-
- Clinical Cardiac Electrophysiology Physician
- La Porte, IN
- NPI 1003093824
-
- Psychiatry Physician
- Johnson City, TN
- NPI 1841283199
-
- Surgical Critical Care Physician
- La Crosse, WI
- NPI 1356410898
-
- Critical Care Medicine (Internal Medicine) Physician
- Leonardtown, MD
- NPI 1003174707
DC, VA
-
- Pulmonary Disease Physician
- Greenwood, IN
- NPI 1841547692
Critical Care Medicine
-
- Neurology Physician
- Charlottesville, VA
- NPI 1194894725
-
- Internal Medicine Physician
- Boston, MA
- NPI 1235570375
AL, Critical Care Medicine
-
- Critical Care Medicine (Internal Medicine) Physician
- Scottsdale, AZ
- NPI 1578900858
CO
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538352000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1745798400000",
"number": "1245715796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 631797",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452631797",
"telephone_number": "845-702-2711",
"fax_number": "888-220-6560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 N WASHINGTON ST",
"city": "SUMTER",
"state": "SC",
"postal_code": "291504949",
"telephone_number": "803-774-9000"
}
],
"practiceLocations": [
{
"address_1": "120 N Delaware St",
"address_purpose": "LOCATION",
"city": "Sandusky",
"state": "MI",
"postal_code": "484711009",
"country_code": "US",
"telephone_number": "810-648-3770",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "350 Boulevard",
"address_purpose": "LOCATION",
"city": "Passaic",
"state": "NJ",
"postal_code": "070552840",
"country_code": "US",
"telephone_number": "973-365-4300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "425 W 5th St",
"address_purpose": "LOCATION",
"city": "East Liverpool",
"state": "OH",
"postal_code": "439202405",
"country_code": "US",
"telephone_number": "330-385-7200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5315 E Larkspur Dr",
"address_purpose": "LOCATION",
"city": "Scottsdale",
"state": "AZ",
"postal_code": "852544227",
"country_code": "US",
"telephone_number": "845-702-2711",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1015 Priory Pl",
"address_purpose": "LOCATION",
"city": "Mc Lean",
"state": "VA",
"postal_code": "221012134",
"country_code": "US",
"telephone_number": "845-702-2711",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "120 Leeuwarden Rd",
"address_purpose": "LOCATION",
"city": "Darien",
"state": "CT",
"postal_code": "068203027",
"country_code": "US",
"telephone_number": "845-702-2711",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "625 Gore Range Dr",
"address_purpose": "LOCATION",
"city": "Severance",
"state": "CO",
"postal_code": "805504869",
"country_code": "US",
"telephone_number": "845-702-2711",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "27 Henderson St",
"address_purpose": "LOCATION",
"city": "Arlington",
"state": "MA",
"postal_code": "024745507",
"country_code": "US",
"telephone_number": "845-702-2711",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5605 Poola St",
"address_purpose": "LOCATION",
"city": "Honolulu",
"state": "HI",
"postal_code": "968211564",
"country_code": "US",
"telephone_number": "845-702-2711",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "386 Acadian Ct",
"address_purpose": "LOCATION",
"city": "Biloxi",
"state": "MS",
"postal_code": "395312900",
"country_code": "US",
"telephone_number": "845-702-2711",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1481 Hollis Rdg",
"address_purpose": "LOCATION",
"city": "Clarksville",
"state": "TN",
"postal_code": "370431522",
"country_code": "US",
"telephone_number": "845-702-2711",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "201 NW R D Mize Rd",
"address_purpose": "LOCATION",
"city": "Blue Springs",
"state": "MO",
"postal_code": "640142513",
"country_code": "US",
"telephone_number": "816-228-5900",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "425 W 5th St",
"address_purpose": "LOCATION",
"city": "East Liverpool",
"state": "OH",
"postal_code": "439202498",
"country_code": "US",
"telephone_number": "330-385-7200",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "600 S Monroe St",
"address_purpose": "LOCATION",
"city": "Enid",
"state": "OK",
"postal_code": "737017211",
"country_code": "US",
"telephone_number": "580-233-2300",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "59-351 Lehiwa Pl",
"address_purpose": "LOCATION",
"city": "Kamuela",
"state": "HI",
"postal_code": "967438581",
"country_code": "US",
"telephone_number": "845-702-2711",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10 Nadia S Way",
"address_purpose": "LOCATION",
"city": "Farmington",
"state": "CT",
"postal_code": "060322860",
"country_code": "US",
"telephone_number": "845-702-2711",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6565 Fannin St",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770302703",
"country_code": "US",
"telephone_number": "713-790-3311",
"fax_number": "888-220-6560",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CCMMA SC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-01",
"last_updated": "2025-04-28",
"certification_date": "2025-04-28",
"status": "A",
"authorized_official_last_name": "SCURLOCK",
"authorized_official_first_name": "COREY",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "914-523-2189",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sumter, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.