Organization Active NPI

Carolinas Medical Alliance Inc

  • General Practice Physician
  • Florence, SC
National Provider Identifier
1376591206
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CAROLINAS MEDICAL ALLIANCE INC
Practice address
805 Pamplico Hwy
Ste a 320
Florence, SC 29505-6047
Phone
(843) 665-1280
NPI assigned
May 4, 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

805 Pamplico Hwy
Ste a 320
Florence, SC 29505-6047

Mailing address

805 Pamplico Hwy
Ste a 320
Florence, SC 29505-6047
Phone (843) 665-1280

Other identifiers 1

IdentifierTypeStateIssuer
GP3556MedicaidSC

National Provider Directory

National Provider Directory

Locations

805 Pamplico Hwy
Ste A320
Florence, SC 29505
Phone (843) 674-1480

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1376591206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 PAMPLICO HWY",
            "address_2": "STE A 320",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056047",
            "telephone_number": "843-665-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 PAMPLICO HWY",
            "address_2": "STE A 320",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056047",
            "telephone_number": "843-665-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL ALLIANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "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": "GP3556",
            "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.