NPIMap

Organization Active NPI

Carolinas Medical Alliance Inc

  • Family Medicine Physician
  • Florence, SC
National Provider Identifier
1457301848
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAROLINAS MEDICAL ALLIANCE INC
Practice address
805 Pamplico Hwy
Ste a 230
Florence, SC 29505-6047
Phone
(843) 669-1220
NPI assigned
May 10, 2006
Last updated
Dec 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Debbie Brewer
Title
Director of Provider Enrollment
Phone
(615) 465-7000

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X SC
Emergency Medicine Physician 207P00000X SC
Family Medicine Physician 207Q00000X SC Primary
Internal Medicine Physician 207R00000X SC
Obstetrics & Gynecology Physician 207V00000X SC
Surgery Physician 208600000X SC
General Practice Physician 208D00000X SC
Hospitalist Physician 208M00000X SC

Addresses

Primary practice location

805 Pamplico Hwy
Ste a 230
Florence, SC 29505-6047

Mailing address

805 Pamplico Hwy
Ste a 230
Florence, SC 29505-6047
Phone (843) 669-1220

Other identifiers 1

IdentifierTypeStateIssuer
GP4003MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Carolinas Hospital System4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1457301848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 PAMPLICO HWY",
            "address_2": "STE A 230",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056047",
            "telephone_number": "843-669-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 PAMPLICO HWY",
            "address_2": "STE A 230",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056047",
            "telephone_number": "843-669-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL ALLIANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "615-465-7000"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4003",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.