NPIMap

Organization Active NPI

Minuteclinic Diagnostic South Carolina LLC

  • Family Nurse Practitioner
  • Simpsonville, SC
National Provider Identifier
1447420815
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MINUTECLINIC DIAGNOSTIC SOUTH CAROLINA LLC
Practice address
698 Fairview Rd
Simpsonville, SC 29680-6708
Phone
(866) 389-2727
Fax
(401) 406-3539
NPI assigned
Mar 3, 2008
Last updated
Jun 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Authorized official

Name
Deborah Pincince
Title
Administrator
Phone
(401) 770-3813

Specialties & licenses 1

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

Addresses

Primary practice location

698 Fairview Rd
Simpsonville, SC 29680-6708

Mailing address

PO Box 772
Minuteclinic Credentialing
Woonsocket, RI 02895-0784
Phone (866) 389-2727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081015000409 SC Part B Supplier - Clinic/Group Practice 8527126861 Receives reassigned benefits from 174 practitioners
Practice locations: North Charleston, SC; Moore, SC; Mount Pleasant, SC; Murrells Inlet, SC; Myrtle Beach, SC; North Augusta, SC; Mauldin, SC; North Myrtle Beach, SC…

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2062 Whiskey Rd
Aiken, SC 29803
Phone (803) 648-2339

1300 Tiger Blvd
Clemson, SC 29631
Phone (864) 653-6724

121 Clemson Rd
Columbia, SC 29229
Phone (803) 419-4002

2996 E Highway 501
Conway, SC 29526
Phone (843) 347-2613

5269 Calhoun Memorial Hwy
Easley, SC 29640
Phone (864) 859-7168

10 Pope Ave
Hilton Head Island, SC 29928
Phone (843) 785-7786

1330 Dutch Fork Rd
Irmo, SC 29063
Phone (803) 749-1666

9625 Highway 78
Ladson, SC 29456
Phone (843) 818-1190

1071 S Lake Dr
Lexington, SC 29073
Phone (803) 957-0605

932 N Lake Dr
Lexington, SC 29072
Phone (803) 957-5322

1888 Boiling Springs Rd
Spartanburg, SC 29316
Phone (864) 599-0820

Practitioners & affiliated clinicians

Practitioners 177

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.

View all 177

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1447420815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772",
            "address_2": "MINUTECLINIC CREDENTIALING",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028950784",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 FAIRVIEW RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296806708",
            "telephone_number": "866-389-2727",
            "fax_number": "401-406-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINUTECLINIC DIAGNOSTIC SOUTH CAROLINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.