NPIMap

Organization Active NPI

Kershaw Hospital LLC

  • Urgent Care Clinic/Center
  • Elgin, SC
National Provider Identifier
1508094913
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
KERSHAW HOSPITAL LLC
Practice address
40 Pinnacle Parkway
Building 100
Elgin, SC 29045
Phone
(803) 432-4311
NPI assigned
Jun 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
Terrance Dillon
Title
Assistant Secretary
Phone
(502) 596-7220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

40 Pinnacle Parkway
Building 100
Elgin, SC 29045

Mailing address

40 Pinnacle Parkway
Building 100
Elgin, SC 29045
Phone (803) 424-5160

Other identifiers 2

IdentifierTypeStateIssuer
GP7138MedicaidSC
GP5297MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1508094913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PINNACLE PARKWAY",
            "address_2": "BUILDING 100",
            "city": "ELGIN",
            "state": "SC",
            "postal_code": "29045",
            "telephone_number": "803-424-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 PINNACLE PARKWAY",
            "address_2": "BUILDING 100",
            "city": "ELGIN",
            "state": "SC",
            "postal_code": "29045",
            "telephone_number": "803-432-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERSHAW HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-24",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "502-596-7220"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7138",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5297",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.