NPIMap

Organization Active NPI

Carolina Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Greenwood, SC
National Provider Identifier
1518338698
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CAROLINA HEALTH CENTERS, INC.
Practice address
420 Epting Ave # B
Greenwood, SC 29646-4040
Phone
(864) 941-8121
Fax
(864) 330-8237
NPI assigned
Oct 14, 2015
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Lisa Y Gilmer
Title
Revenue Cycle Manager
Phone
(864) 941-8121

Owners & managing parties with NPI records 1

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

Other NPIs on the same Medicare enrollment 10

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

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 11

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

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 34

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2101356Village Family Practice420 Epting Ave, Suite B, Greenwood, SC 29646Provider-performed microscopyJun 1, 2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Federally qualified health center certification: CCN 421042

Medicare enrollment files
Legal name
CAROLINA HEALTH CENTERS INC
Doing business as
VILLAGE FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 18, 2016
Last certification
Jul 18, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 27, 1977 in SC
Enrollment address
420 Epting Ave B
Greenwood, SC 29646-4040

All disclosed owners & managing parties 12

Medicare enrollment files

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

NameRoleSinceShare
Christopher Scott Clem Individual Corporate OfficerCfo Jun 16, 2025
W-2 Managing EmployeeCfo Jun 16, 2025
Mary Stackhouse Individual Corporate DirectorBoard Member Mar 26, 1998
Abby Banks Individual Corporate DirectorBoard Member Mar 27, 2017
Kimberly Kapetanakos Individual Corporate DirectorBoard Member Mar 17, 2017
Miriam Ferguson Individual Corporate OfficerCeo Jul 14, 2025 100%
Mario Luna Individual Corporate DirectorBoard Member Sep 29, 2014
Gail D Ferguson Individual Corporate DirectorBoard Member Jul 1, 1994
John Britt Individual Corporate OfficerChairman of Board Mar 25, 1985
Corporate DirectorBoard Member Mar 25, 1985
Gregory Bullard Individual Corporate OfficerVice Chairman, Finance Committee Jun 24, 1982
Corporate DirectorBoard Member Jun 24, 1985
Deborah Natvig Individual Corporate DirectorBoard Member Feb 22, 2010
Paul Grogan Individual Corporate OfficerChief Financial Officer Aug 6, 2012
Locke Eugene Simons Individual Corporate OfficerChief Medical Officer Apr 12, 2012

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20050825000437 SC Part B Supplier - Clinic/Group Practice 5496707804 Receives reassigned benefits from 37 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ridge Spring, SC; Waterloo, SC; Ware Shoals, SC; Saluda, SC; MC Cormick, SC; Greenwood, SC; Clinton, SC; Calhoun Falls, SC
O20151204000293 SC Part a Provider - Federally Qualified Health Center (FQHC) 5496707804 Practice locations: Greenwood, SC

National Provider Directory

National Provider Directory
Tax ID family
Carolina Health Centers Inc (12 organizations share this tax ID)

Locations

14955 W 151st St
Olathe, KS 66062
Phone (913) 323-8890

12541 Foster St
Ste 330
Overland Park, KS 66213
Phone (913) 345-2322

5844 NW Barry Rd
Kansas City, MO 64154
Phone (816) 584-1674

4321 Washington St
Ste 4000
Kansas City, MO 64111
Phone (816) 932-4549

901 E 104th St
Stop 400N
Kansas City, MO 64131

2737 NE McBaine Dr
Lees Summit, MO 64064
Phone (816) 251-5780

93 S Greenwood Ave
Ware Shoals, SC 29692
Phone (864) 456-7436

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

NPPES NPI Registry

Primary practice location

420 Epting Ave # B
Greenwood, SC 29646-4040

Mailing address

313 Main St Ste B
Greenwood, SC 29646-2757
Phone (864) 388-0301

Other names 1

NPPES NPI Registry
  • Village Family Practice Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 14, 2015.

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1518338698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 MAIN ST STE B",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462757",
            "telephone_number": "864-388-0301",
            "fax_number": "864-388-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 EPTING AVE # B",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296464040",
            "telephone_number": "864-941-8121",
            "fax_number": "864-330-8237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "GILMER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "864-941-8121"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.