Young Men'S Christian Association of the Upper Pee Dee

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE UPPER PEE DEE

Practice address

110 E Carolina Ave
Hartsville, SC 29550-4214

Phone

(343) 383-4547

Fax

(843) 383-0982

NPI assigned

Sep 27, 2016

Organization subpart

No

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

Authorized official

Name

Shawn Patch

Title

Ceo

Phone

(843) 383-4547

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1396294740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E CAROLINA AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504214",
            "telephone_number": "343-383-4547",
            "fax_number": "843-383-0982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E CAROLINA AVE",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504214",
            "telephone_number": "343-383-4547",
            "fax_number": "843-383-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE UPPER PEE DEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-27",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "PATCH",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-383-4547"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikaylah Kiara Wingate
• Tracie Mixon Woodward, NP
• Heather Michelle Worsham, PNP
• Aaron Thomas Wynkoop
• Yvette York
• Pamela Youngblood, R.PH.
• Madge W Zemp, LPC
• Amber Rose Zimmerman, OT

• Health Educator in Hartsville, SC
• Providers in Hartsville, SC by specialty
• Health Educator in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.