NPIMap

Organization Active NPI

Carolinas Medical Alliance Inc

  • General Practice Physician
  • Florence, SC
National Provider Identifier
1316904667
Registry record updated Aug 17, 2007
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Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CAROLINAS MEDICAL ALLIANCE INC
Practice address
1925 Hoffmeyer Rd
Florence, SC 29501-4011
Phone
(843) 679-4214
NPI assigned
Apr 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Authorized official

Name
Debbie Brewer
Title
Director of Provider Enrollment
Phone
(615) 465-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1925 Hoffmeyer Rd
Florence, SC 29501-4011

Mailing address

1925 Hoffmeyer Rd
Florence, SC 29501-4011
Phone (843) 679-4214

Other identifiers 1

IdentifierTypeStateIssuer
GP3747MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1316904667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 HOFFMEYER RD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014011",
            "telephone_number": "843-679-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 HOFFMEYER RD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014011",
            "telephone_number": "843-679-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL ALLIANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "615-465-7000"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3747",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; 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.