Southeast Pulmonary and Critical Care LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

21599 Issued in SC

Legal business name

SOUTHEAST PULMONARY AND CRITICAL CARE LLC

Practice address

370 S Herlong Ave
Suite 200
Rock Hill, SC 29732-1160

Phone

(803) 980-5864

Fax

(803) 980-5817

NPI assigned

Feb 23, 2011

Last updated

Sep 9, 2026By 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

Clay W Spence

Title

Administrator

Phone

(803) 980-5864

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3719/brand/1/csg/1/fhir/r4

Practitioners 6

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.

• Nicole I Crawford

  • Family Nurse Practitioner
  • Easley, SC
  • NPI 1376197335
  Medicare reassignment Care Compare group NPD
• Michael B Denenberg, M.D.

  • Pulmonary Disease Physician
  • Rock Hill, SC
  • NPI 1538173794
  Medicare reassignment Care Compare group NPD
• Abbas Mansour, M.D.

  • Pulmonary Disease Physician
  • Easley, SC
  • NPI 1326092156
  Medicare reassignment Care Compare group NPD
• Kaymie Poldo, APRN

  • Adult Health Nurse Practitioner
  • Rock Hill, SC
  • NPI 1053879270
  Medicare reassignment Care Compare group NPD
• Brittany Root Simon

  • Primary Care Nurse Practitioner
  • Rock Hill, SC
  • NPI 1639878895
  Medicare reassignment Care Compare group NPD
• Jennifer E Peelman, PA-C

  • Medical Physician Assistant
  • Rock Hill, SC
  • NPI 1992057285
  Medicare reassignment

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1275830507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 HERLONG AVE S STE 200",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321160",
            "telephone_number": "803-980-5864",
            "fax_number": "803-980-5817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 S HERLONG AVE",
            "address_2": "SUITE 200",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321160",
            "telephone_number": "803-980-5864",
            "fax_number": "803-980-5817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1454 Gentry Memorial Hwy",
            "address_purpose": "LOCATION",
            "city": "Easley",
            "state": "SC",
            "postal_code": "296406940",
            "country_code": "US",
            "telephone_number": "864-850-0700",
            "fax_number": "864-850-0705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Richard St Ste B",
            "address_purpose": "LOCATION",
            "city": "Easley",
            "state": "SC",
            "postal_code": "296401442",
            "country_code": "US",
            "telephone_number": "864-850-0700",
            "fax_number": "864-850-0705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHEAST PULMONARY AND CRITICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-23",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "SPENCE",
        "authorized_official_first_name": "CLAY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "803-980-5864"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "SC",
            "license": "21599",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SC",
            "license": "21599",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215992",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Medical Specialty Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.