Organization Active NPI

Partners for Change of the Carolinas

  • Multi-Specialty Clinic/Center
  • Sumter, SC
National Provider Identifier
1356786750
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PARTNERS FOR CHANGE OF THE CAROLINAS
Practice address
110 South Washington Street
Sumter, SC 29150
Phone
(803) 360-7896
Fax
(803) 888-2648
NPI assigned
Apr 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Authorized official

Name
Valencia Giselle Gray-Williams, PHARMDNPI 1841286481
Title
Director
Phone
(803) 360-7896

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

110 South Washington Street
Sumter, SC 29150

Mailing address

110 South Washington Street
Sumter, SC 29150
Phone (803) 360-7896

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidSC

National Provider Directory

National Provider Directory

Locations

337 Manning Ave
Sumter, SC 29150
Phone (803) 968-4123

110 S Washington St
Sumter, SC 29150
Phone (803) 360-7896

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1356786750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SOUTH WASHINGTON STREET",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "29150",
            "telephone_number": "803-360-7896",
            "fax_number": "803-888-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SOUTH WASHINGTON STREET",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "29150",
            "telephone_number": "803-360-7896",
            "fax_number": "803-888-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERS FOR CHANGE OF THE CAROLINAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "GRAY-WILLIAMS",
        "authorized_official_first_name": "VALENCIA",
        "authorized_official_middle_name": "GISELLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "803-360-7896",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "SC"
        }
    ],
    "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 Feb 15, 2022; 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.