NPIMap

Organization Active NPI

Rural Health Services, Inc

Doing business as Clyburn Center for Primary Care

  • Federally Qualified Health Center (FQHC)
  • Aiken, SC
National Provider Identifier
1447530431
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RURAL HEALTH SERVICES, INC
Doing business as
Clyburn Center for Primary Care
DBA Clyburn Center for Primary Care
Practice address
1000 Clyburn PL
Aiken, SC 29801-4193
Phone
(803) 380-7000
Fax
(803) 502-8491
NPI assigned
Aug 22, 2011
Last updated
Apr 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Mark C. Hedman
Title
Authorized Official
Phone
(803) 380-7001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1000 Clyburn PL
Aiken, SC 29801-4193

Mailing address

1000 Clyburn PL
Aiken, SC 29801-4193
Phone (803) 380-7000

Other identifiers 1

IdentifierTypeStateIssuer
FQC156MedicaidSC

Other names 2

  • Clyburn Center for Primary Care Doing business as
  • DBA Clyburn Center for Primary Care Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120411000025 SC Part A Provider - Federally Qualified Health Center (FQHC) 8527046010 Practice locations: Aiken, SC
O20150430001494 SC Part B Supplier - Clinic/Group Practice 8527046010 Receives reassigned benefits from 28 practitioners
1 other NPI on this enrollment
Practice locations: Aiken, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447530431. Details of each certification follow.

Federally qualified health center certification: CCN 421953

Legal name
RURAL HEALTH SERVICES, INC.
Doing business as
CLYBURN CENTER FOR PRIMARY CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 11, 2012
Last certification
Apr 11, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1000 Clyburn Place
Aiken, SC 29801-4193

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 1

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Gary Farina Individual Corporate OfficerBoard Member Oct 28, 2023
Josh Carias Individual Corporate OfficerBoard Member Oct 28, 2023
Donald Branum Individual Corporate OfficerCeo Aug 30, 2024
Geneva Jackson Individual Corporate OfficerBoard Member Oct 28, 2023
Heather Hayes Individual W-2 Managing EmployeeCredentialing Specialist Aug 30, 2024
Sherry L Fuehrer Individual W-2 Managing EmployeeBilling Manager Oct 14, 2024
Joshua Booth Individual Corporate OfficerVice Chair Oct 28, 2023
Marisol Fuentes Individual Corporate OfficerTreasurer Oct 28, 2023
Elizabeth Stewart Individual Corporate OfficerBoard Chair Jan 1, 2016
Corporate DirectorBoard Chair Mar 17, 2011
Cynthia Mitchell Individual Corporate DirectorBoard Member Oct 28, 2023
Karla Morrison Individual W-2 Managing EmployeeCredentialing Specialist Aug 30, 2024
Cory Murphy Individual Corporate OfficerBoard Member Oct 28, 2023
Kristin Allen Individual Corporate OfficerSecretary Oct 28, 2023
Nicholas McCarley Individual Corporate OfficerBoard Member Jan 1, 2016
Rural Health Services, Inc. Organization, Aiken, SC Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2011 100%
Thayer McGahee Individual Corporate OfficerBoard Member Oct 28, 2023

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
Family Health CenterAiken, SC, CCN 421952 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2011

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 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1447530431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CLYBURN PL",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298014193",
            "telephone_number": "803-380-7000",
            "fax_number": "803-502-4248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CLYBURN PL",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298014193",
            "telephone_number": "803-380-7000",
            "fax_number": "803-502-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-22",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "HEDMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "803-380-7001"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FQC156",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clyburn Center for Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DBA Clyburn Center for Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.