NPIMap

Organization Active NPI

Little River Medical Center, Inc.

  • Dentist
  • Little River, SC
National Provider Identifier
1467635342
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LITTLE RIVER MEDICAL CENTER, INC.
Practice address
287 Highway 90 E
Suite 3
Little River, SC 29566-7214
Phone
(843) 663-1013
Fax
(843) 663-1017
NPI assigned
Dec 13, 2007
Organization subpart
Yes
Parent organization
LITTLE RIVER MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Authorized official

Name
Mrs. Chari L Sherrill, ADMINISTRATIVE
Title
Credentialer
Phone
(843) 663-1013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

287 Highway 90 E
Suite 3
Little River, SC 29566-7214

Mailing address

PO Box 547
Suite 3
Little River, SC 29566-0547
Phone (843) 663-1013

Other identifiers 1

IdentifierTypeStateIssuer
ZA9656MedicaidSC

Other names 1

  • Pee Dee Elementary Other name

National Provider Directory

National Provider Directory
Tax ID family
Little River Medical Center Inc26 organizations share this tax ID, including this one
Part of
Little River Medical Center Inc

Other organizations with this tax ID 25

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

View all 25

Locations

287 Highway 90 E
Ste 3
Little River, SC 29566

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1467635342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "address_2": "SUITE 3",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295660547",
            "telephone_number": "843-663-1013",
            "fax_number": "843-663-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 HIGHWAY 90 E",
            "address_2": "SUITE 3",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295667214",
            "telephone_number": "843-663-1013",
            "fax_number": "843-663-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE RIVER MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LITTLE RIVER MEDICAL CENTER, INC.",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "SHERRILL",
        "authorized_official_first_name": "CHARI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALER",
        "authorized_official_telephone_number": "843-663-1013",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINISTRATIVE"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9656",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pee Dee Elementary",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Little River, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.