NPIMap

Organization Active NPI

Newberry County Memorial Hospital

Doing business as Little Mountain Family Health Center

  • Rural Health Clinic/Center
  • Little Mountain, SC
National Provider Identifier
1417182783
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
NEWBERRY COUNTY MEMORIAL HOSPITAL
Doing business as
Little Mountain Family Health Center
Practice address
99 N Mill St
Little Mountain, SC 29075-8788
Phone
(803) 945-1005
NPI assigned
May 15, 2009
Last updated
Dec 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Authorized official

Name
Michael L Reynolds
Title
Chief Financial Officer
Phone
(803) 405-7469

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X SC Primary

Addresses

Primary practice location

99 N Mill St
Little Mountain, SC 29075-8788

Mailing address

99 N Mill St
Little Mountain, SC 29075-8788
Phone (803) 945-1005

Other names 1

  • Little Mountain Family Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041007000264 SC Part B Supplier - Clinic/Group Practice 8123927464 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Little Mountain, SC; Whitmire, SC; Newberry, SC

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Newberry Cty Memorial Hosp13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1242345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1417182783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 N MILL ST",
            "city": "LITTLE MOUNTAIN",
            "state": "SC",
            "postal_code": "290758788",
            "telephone_number": "803-945-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 N MILL ST",
            "city": "LITTLE MOUNTAIN",
            "state": "SC",
            "postal_code": "290758788",
            "telephone_number": "803-945-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBERRY COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-15",
        "last_updated": "2011-12-02",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "803-405-7469"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little Mountain Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Little Mountain, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.