Edisto Regional Health Services Inc.
Organization Active NPI Rural Health Clinic/Center · Branchville, SC
NPI 1487701157 · NPPES record last updated Oct 19, 2015
Key facts
- NPI
- 1487701157
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- EDISTO REGIONAL HEALTH SERVICES INC.
- Practice address
- 215 Dorange Rd
Branchville, SC 29432-2241 - Phone
- (803) 274-8400
- Fax
- (803) 274-8817
- NPI assigned
- Jan 4, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- EDISTO REGIONAL HEALTH SERVICES INC.
Authorized official
- Name
- Cheryl S. Mason
- Title
- C.F.O.
- Phone
- (803) 395-2224
Other NPIs on the same Medicare enrollment 17
Member of 1
Change of ownership 1
Practitioners 4
-
Rachel Danford, DNP,APRN,NP-C,FNP-BC
-
Angela Hampton, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Mar 1, 2023 | Change of Ownership |
Musc Community Physicians |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040810000307 | SC | Part B Supplier - Clinic/Group Practice | 4981693447 |
Receives reassigned benefits from 41 practitioners 17 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bowman, SC; Bamberg, SC; Santee, SC; Saint Matthews, SC; Orangeburg, SC; Holly Hill, SC; Branchville, SC |
National Provider Directory
- Part of
- Low Country Pain Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
215 Dorange Rd
Branchville, SC 29432-2241
Mailing address
PO Box 1245
Orangeburg, SC 29116-1245
Phone (803) 395-4497
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CK8831 | Other | SC | RRMEDICARE |
| CN8991 | Other | SC | RRMEDICARE |
| 012 | Other | SC | BLUECHOICE |
| 423856 | Other | SC | MEDICARE RURAL HEALTH NUMBER |
| RHC165 | Medicaid | SC | |
| GP4574 | Medicaid | SC | |
| 012 | Other | SC | BCBS |
| 012 | Other | SC | TRICARE |
Other names
- RMC Primary Care Branchville
Other providers in Branchville, SC
- Evelyn Berry
- Edisto Regional Health Services
- Amber Berry Heape
- Magnolias of Branchville
- Musc Community Physicians
- William E Oquinn
- Lauren Murphy Ott
All providers in Branchville, SC · Rural Health Clinic/Center in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.