NPIMap

Organization Active NPI

Medical University Hospital Authority

Doing business as MUSC Health Kershaw Medical Center

  • General Acute Care Hospital
  • Camden, SC
National Provider Identifier
1487220307
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MEDICAL UNIVERSITY HOSPITAL AUTHORITY
Doing business as
MUSC Health Kershaw Medical Center
Practice address
1315 Roberts St
Camden, SC 29020-3737
Phone
(803) 432-4311
NPI assigned
Jun 1, 2021
Last updated
May 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Authorized official

Name
Karyn Rae
Title
Chair
Phone
(843) 876-1344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

1315 Roberts St
Camden, SC 29020-3737

Mailing address

PO Box 23469
New York, NY 10087-3469
Phone (843) 792-1414

Other names 1

  • MUSC Health Kershaw Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20210826000619 SC Part A Provider - Hospital 1557268950 1 other NPI on this enrollment
Practice locations: Camden, SC; Elgin, SC; Lugoff, SC
O20211012002683 SC Part A Provider - Hospital 1557268950 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Camden, SC
O20231024003906 SC Part B Supplier - Intensive Cardiac Rehabilitation 1557268950 Practice locations: Camden, SC

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1487220307. Details of each certification follow.

Hospital certification: CCN 420048

Legal name
MEDICAL UNIVERSITY HOSPITAL AUTHORITY
Doing business as
KERSHAW MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Dec 16, 2021
Beds
119
Ownership / control type
Private (for profit)
Most recent change of ownership
Nov 1, 2015 (1 total)
Organization structure
OtherNon-profit
Enrollment address
1315 Roberts St
Camden, SC 29020-3737
Main/Primary Hospital Location
Hospital subgroups
Acute care

Hospital certification: CCN 42S048

Legal name
MEDICAL UNIVERSITY HOSPITAL AUTHORITY
Doing business as
KERSHAW MEDICAL CENTER
Organization structure
OtherProprietary
Enrollment address
1315 Roberts St
Camden, SC 29020-3737
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
KershawhealthCCN 420048 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

677 Ala Moana Blvd
Ste 306
Honolulu, HI 96813

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Barbara Johnson Williams Individual Corporate Director Jan 1, 2026
William M Brown Individual Corporate Director Jan 1, 2026
Michael Stavrinakis Individual Corporate Director Jan 1, 2026
Douglas E Lischke Individual W-2 Managing EmployeeCfo Dec 1, 2024
Terri Barnes Individual Corporate Director Jan 1, 2026
Bartlett J Witherspoon Individual Corporate Director Jan 1, 2026
James Lemon Individual Corporate Director Jan 1, 2026
Medical University of South Carolina Organization, Charleston, SC Non-profit Operational/Managerial Control Mar 1, 2019
Sonya Floyd Individual W-2 Managing EmployeeManager, Provider Enrollment and Aug 1, 2021
W-2 Managing EmployeeManager/Provider Enrollment &Con Aug 1, 2021
Henry Frederick Butehorn Individual Corporate Director Jan 1, 2026
Karyn Rae Individual Corporate DirectorChief,Payor Relations, Reimburse Aug 1, 2021
Corporate DirectorChief Payor Relations & Reimburs Aug 1, 2021
Patrick J Cawley Individual Corporate OfficerCeo Aug 1, 2021
Charles Castles Individual Corporate Director Jan 1, 2026
Thomas Stephenson Individual Corporate Director Jan 1, 2026
George M Smith Individual Corporate Director Jan 1, 2026
Donald Roger Johnson Individual Corporate Director Jan 1, 2026
Charles Schulze Individual Corporate Director Jan 1, 2026
Richard M Christian Individual Corporate Director Jan 1, 2026
Lisa M Goodlett Individual Corporate OfficerCfo Aug 1, 2021

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 11

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

FacilityTypeRoleSince
Tidelands Waccamaw Community HospitalMurrells Inlet, SC, CCN 420098 Hospital Operational/Managerial Control Oct 1, 2025
Tidelands Georgetown Memorial HospitalGeorgetown, SC, CCN 420020 Hospital Operational/Managerial Control Oct 1, 2025
Musc Health Lancaster Medical CenterLancaster, SC, CCN 429803 Hospital Operational/Managerial Control (100%) Mar 1, 2019
Musc Health Lancaster Rehabilitation CenterLancaster, SC, CCN 42T036 Hospital Operational/Managerial Control (100%) Mar 1, 2019
Tidelands Georgetown Memorial HospitalGeorgetown, SC, CCN 42U020 Hospital Operational/Managerial Control Oct 1, 2025
Tidelands Health Family Medicine at GeorgetownGeorgetown, SC, CCN 428958 Rural health clinic Operational/Managerial Control Oct 1, 2020
Tidelands Health Family Medicine at HemingwayHemingway, SC, CCN 423859 Rural health clinic Operational/Managerial Control Oct 1, 2025
Tidelands Health Family MedicineAndrews, SC, CCN 423970 Rural health clinic Operational/Managerial Control Oct 1, 2025
Tidelands Health Family Medicine at Pawleys IslandPawleys Island, SC, CCN 423870 Rural health clinic Operational/Managerial Control Oct 1, 2025
Musc Health Primary Care - Thurgood Marshall BlvdKingstree, SC, CCN 423448 Rural health clinic Operational/Managerial Control (100%) Dec 1, 2022
Musc Community PhysiciansBranchville, SC, CCN 423856 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2021

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Practitioners 6

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.

Affiliated clinicians 359

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 359

NPI Registry JSON

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1487220307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23469",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873469",
            "telephone_number": "843-792-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 ROBERTS ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203737",
            "telephone_number": "803-432-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL UNIVERSITY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-01",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A",
        "authorized_official_last_name": "RAE",
        "authorized_official_first_name": "KARYN",
        "authorized_official_title_or_position": "CHAIR",
        "authorized_official_telephone_number": "843-876-1344"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MUSC Health Kershaw Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MUSC Health Kershaw Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camden, SC

Sources for this page

Verify at the official NPI Registry.