NPIMap

Organization Active NPI

Gold Star Urgent Care LLC

  • Urgent Care Clinic/Center
  • Florence, SC
National Provider Identifier
1528643608
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
GOLD STAR URGENT CARE LLC
Practice address
514 2ND Loop Rd Ste E
Florence, SC 29505-2848
Phone
(843) 407-4451
NPI assigned
Mar 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Latoya Sierra Lane-Milo, APRNNPI 1548809817
Title
Nurse Practitioner
Phone
(843) 506-9836

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

514 2ND Loop Rd Ste E
Florence, SC 29505-2848

Mailing address

960 Pamplico Hwy Ste L
Florence, SC 29505-6244
Phone (843) 804-6689

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Goldstarurgentcare@gmail.com Direct
CONNECT URL info@goldstarurgentcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210401001639 SC Part B Supplier - Clinic/Group Practice 2466869706 Receives reassigned benefits from 5 practitioners
Practice locations: Florence, SC

National Provider Directory

National Provider Directory
Tax ID family
Gold Star Urgent Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

514 2nd Loop Rd
Ste E
Florence, SC 29505
Phone (843) 407-4451

512 2nd Loop Rd
Florence, SC 29505

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1528643608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 PAMPLICO HWY STE L",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056244",
            "telephone_number": "843-804-6689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 2ND LOOP RD STE E",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295052848",
            "telephone_number": "843-407-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD STAR URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-10",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "LANE-MILO",
        "authorized_official_first_name": "LATOYA",
        "authorized_official_middle_name": "SIERRA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "843-506-9836",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Goldstarurgentcare@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2288 Richmond Hills Dr",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295056857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@goldstarurgentcare.com",
            "affiliation": "N",
            "address_1": "514 2nd Loop Rd Ste E",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295052848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.