NPIMap

Organization Active NPI

Little River Medical Center

  • Family Medicine Physician
  • Little River, SC
National Provider Identifier
1316102106
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LITTLE RIVER MEDICAL CENTER
Practice address
4303 Live Oak Dr
Little River, SC 29566-9138
Phone
(843) 663-1013
Fax
(843) 663-1017
NPI assigned
Jul 22, 2008
Last updated
Jul 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Authorized official

Name
Mrs. Kay Criswell
Title
Business Office Manager
Phone
(843) 663-1013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

4303 Live Oak Dr
Little River, SC 29566-9138

Mailing address

4303 Live Oak Dr
Little River, SC 29566-9138
Phone (843) 663-1013

Other identifiers 1

IdentifierTypeStateIssuer
CBP024MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Little River Medical Ce26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1316102106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4303 LIVE OAK DR",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295669138",
            "telephone_number": "843-663-1013",
            "fax_number": "843-663-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 LIVE OAK DR",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295669138",
            "telephone_number": "843-663-1013",
            "fax_number": "843-663-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE RIVER MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "CRISWELL",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "843-663-1013",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CBP024",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little River, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.