Serenity Manor

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

12184-C07 Issued in SC

Legal business name

SERENITY MANOR

Practice address

4018 S Rhett Ave
N Charleston, SC 29405-7163

Phone

(843) 554-0733

NPI assigned

Jun 24, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Hattie Fields, RNNPI 1902246697

Title

Administrator

Phone

(843) 554-0733

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Hattie B Fields, RN

  • Registered Nurse
  • Charleston, SC
  • NPI 1902246697
  NPD (past) Authorized official

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372032000000",
    "number": "1336588243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21934",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294131934",
            "telephone_number": "843-554-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4018 S RHETT AVE",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294057163",
            "telephone_number": "843-554-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "HATTIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "843-554-0733",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "SC",
            "license": "12184-C07",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RC1472",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nessie Pollard Schrom, OTRL SIPTA
• Lance Thomas Schuemann, ATC
• Michelle R Scott
• Gretchen Seif, PT PHYSICAL THERAPY
• Select Health of South Carolina, Inc.
• Niravkumar Shah, PT, DPT
• Thomas Eugene Sherer, R.PH
• Lisa Short, RN
• Jack L Shortridge, ED.D.
• Sarah Doobrow Silvis, P.A.

• Physical Disabilities Residential Treatment Facility in N Charleston, SC
• Providers in N Charleston, SC by specialty
• Physical Disabilities Residential Treatment Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.