NPIMap

Organization Active NPI

Bamberg Job Corp.

  • Family Nurse Practitioner
  • Bamberg, SC
National Provider Identifier
1386997591
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
BAMBERG JOB CORP.
Practice address
19 Job Corps Ave
Bamberg, SC 29003-1606
Phone
(803) 245-5101
NPI assigned
Oct 25, 2012
Last updated
Oct 25, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY HEALTH CENTERS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Authorized official

Name
Mr. Leon A Brunson Sr.
Title
Ceo
Phone
(803) 531-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

19 Job Corps Ave
Bamberg, SC 29003-1606

Mailing address

3310 Magnolia St
Orangeburg, SC 29115-1466
Phone (803) 531-6900

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0975487Bamberg Job Corp Center19 Job Corps Avenue, Bamberg, SC 29003Certificate of waiverSep 28, 2026

National Provider Directory

National Provider Directory
Tax ID family
Family Health Center Pharmacy29 organizations share this tax ID, including this one
Part of
Family Health Center Pharmacy

Other organizations with this tax ID 28

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

View all 28

Locations

19 Job Corps Ave
Bamberg, SC 29003
Phone (803) 245-5101

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1386997591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 MAGNOLIA ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291151466",
            "telephone_number": "803-531-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 JOB CORPS AVE",
            "city": "BAMBERG",
            "state": "SC",
            "postal_code": "290031606",
            "telephone_number": "803-245-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAMBERG JOB CORP.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY HEALTH CENTERS, INC.",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "BRUNSON",
        "authorized_official_first_name": "LEON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-531-6900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bamberg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.