Kids Care Medical

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

026544204 Issued in SC

Legal business name

KIDS CARE MEDICAL

Practice address

202 Sherwood Drive
Conway, SC 29526

Phone

(843) 915-0173

Fax

(843) 410-6364

NPI assigned

Jan 5, 2006

Last updated

Jun 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth C Drake

Title

Owner

Phone

(843) 915-0173

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Family Care Medical Former legal business name

Locations

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1396723771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 1196",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "29528",
            "telephone_number": "843-915-0173",
            "fax_number": "843-410-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 SHERWOOD DRIVE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "29526",
            "telephone_number": "843-915-0173",
            "fax_number": "843-410-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS CARE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-05",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-915-0173"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "SC",
            "license": "026544204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE2406",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7703904",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Care Medical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Candace C. Kelly, LMSW
• Denise Cline Kelly
• Nanette C Kelly, FNP-C
• Stephen Jeffrey Kesler
• Kid Care Pediatric Urgent Care, LLC
• Casmir Michal Kielar, MD
• Jason Lee Kiggins, DMD
• Tiara Kind
• Mary K Kindley
• Anna Marie King, MS

• Oxygen Equipment & Supplies (DME) in Conway, SC
• Providers in Conway, SC by specialty
• Oxygen Equipment & Supplies (DME) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.