NPIMap

Organization Active NPI

Careteam Plus, Inc.

  • Federally Qualified Health Center (FQHC)
  • Conway, SC
National Provider Identifier
1427363209
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CARETEAM PLUS, INC.
Practice address
100 Professional Park Drive
Conway, SC 29526-9260
Phone
(843) 234-0005
Fax
(843) 234-8235
NPI assigned
Aug 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Authorized official

Name
Johanna L Haynes
Title
Ceo
Phone
(843) 234-8220

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171M00000X
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

100 Professional Park Drive
Conway, SC 29526-9260

Mailing address

100 Professional Park Drive
Conway, SC 29526-9260
Phone (843) 234-0005

Other identifiers 2

IdentifierTypeStateIssuer
FQC220MedicaidSC
GP5499MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120106000726 SC Part B Supplier - Clinic/Group Practice 2961678289 Receives reassigned benefits from 16 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Conway, SC; Georgetown, SC; Pawleys Island, SC
O20180906002098 SC Part A Provider - Federally Qualified Health Center (FQHC) 2961678289 Practice locations: Conway, SC

Federally qualified health center certification: CCN 421057

Legal name
CARETEAM PLUS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 7, 2018
Last certification
Sep 7, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 24, 1994
Enrollment address
100 Professional Park Dr
Conway, SC 29526-9260

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Careteam Plus Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

100 Professional Park Dr
Conway, SC 29526
Phone (843) 234-0005

132 Professional Park Dr
Conway, SC 29526
Phone (843) 234-0005

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Johanna Haynes Individual Corporate DirectorCeo Apr 1, 2011
W-2 Managing Employee Apr 1, 2011
Careteam Plus Inc Organization, Conway, SC Non-profit 5% Or Greater Direct Ownership Interest Jun 20, 2018 100%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Careteam Plus IncPawleys Island, SC, CCN 421095 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 20, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1427363209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL PARK DRIVE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269260",
            "telephone_number": "843-234-0005",
            "fax_number": "843-234-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL PARK DRIVE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269260",
            "telephone_number": "843-234-0005",
            "fax_number": "843-234-8235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARETEAM PLUS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-17",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "JOHANNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-234-8220"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FQC220",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5499",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.