NPIMap

Organization Active NPI

Sandhills Medical Foundation, Inc

Doing business as Sandhills Medical - West Liberty

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
National Provider Identifier
1386598183
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SANDHILLS MEDICAL FOUNDATION, INC
Doing business as
Sandhills Medical - West Liberty
Practice address
764 W Liberty St
# 1
Sumter, SC 29150-4748
Phone
(803) 778-2446
Fax
(803) 773-7544
NPI assigned
Feb 26, 2026
Last updated
Jun 1, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SANDHILLS MEDICAL FOUNDATION, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Authorized official

Name
Amanda Celeste Duke
Title
Ceo
Phone
(843) 335-8291

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

764 W Liberty St
# 1
Sumter, SC 29150-4748

Mailing address

1111 Broad St
Camden, SC 29020-3611
Phone (843) 335-8291

Other names 1

  • Sandhills Medical - West Liberty Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260519001896 SC Part A Provider - Federally Qualified Health Center (FQHC) 8224949821 Practice locations: Sumter, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386598183. Details of each certification follow.

Federally qualified health center certification: CCN 421135

Legal name
SANDHILLS MEDICAL FOUNDATION, INC.
Doing business as
SANDHILLS MEDICAL - W LIBERTY ST
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 14, 2026
Last certification
May 14, 2026
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
764 W Liberty St
# 1
Sumter, SC 29150-4748

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Sandhills Medical FDN21 organizations share this tax ID, including this one
Part of
Sandhills Medical FDN

Other organizations with this tax ID 20

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

View all 20

Locations

1111 Broad St
Camden, SC 29020

764 W Liberty St
#1
Sumter, SC 29150
Phone (803) 775-3694

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michelle Wooten Individual Corporate DirectorBoard Member Oct 27, 2025
Janet K Defee Individual Corporate DirectorBoard Member Jan 1, 1998
Lavilla Evans Individual Corporate DirectorBoard Member Jan 1, 2006
Ernest Wallace Individual Corporate DirectorBoard Chair Jan 1, 2000
Amanda C Duke Individual Corporate DirectorCeo Oct 9, 2025
W-2 Managing EmployeeCeo Oct 9, 2025
Operational/Managerial ControlCeo Oct 9, 2025
Irene Avery Individual Corporate DirectorBoard Member Jan 27, 2026
Brian Mayes Individual Corporate DirectorBoard Member Oct 24, 2024
David Morales Individual Corporate DirectorBoard Member Mar 23, 2026

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1772064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780272000000",
    "number": "1386598183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BROAD ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203611",
            "telephone_number": "843-335-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 W LIBERTY ST",
            "address_2": "# 1",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504748",
            "telephone_number": "803-778-2446",
            "fax_number": "803-773-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDHILLS MEDICAL FOUNDATION, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANDHILLS MEDICAL FOUNDATION, INC",
        "enumeration_date": "2026-02-26",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A",
        "authorized_official_last_name": "DUKE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "CELESTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-335-8291"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandhills Medical - West Liberty",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.