NPIMap

Organization Active NPI

Windwood Farm Home

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Awendaw, SC
National Provider Identifier
1619047974
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
SR0008106001CCI Issued in SC
Legal business name
WINDWOOD FARM HOME
Practice address
4857 Windwood Farm Rd
Awendaw, SC 29429-5951
Phone
(843) 884-5342
Fax
(843) 884-1287
NPI assigned
Nov 8, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Deborah McKelvey
Title
Ceo
Phone
(843) 884-5342

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X SR0008106001CCI SC Primary

Addresses

Primary practice location

4857 Windwood Farm Rd
Awendaw, SC 29429-5951

Mailing address

4857 Windwood Farm Rd
Awendaw, SC 29429-5951
Phone (843) 884-5342

Other identifiers 1

IdentifierTypeStateIssuer
965MXHMedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Windwood Farm Home5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619047974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4857 WINDWOOD FARM RD",
            "city": "AWENDAW",
            "state": "SC",
            "postal_code": "294295951",
            "telephone_number": "843-884-5342",
            "fax_number": "843-884-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4857 WINDWOOD FARM RD",
            "city": "AWENDAW",
            "state": "SC",
            "postal_code": "294295951",
            "telephone_number": "843-884-5342",
            "fax_number": "843-884-1287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDWOOD FARM HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKELVEY",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-884-5342",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "SC",
            "license": "SR0008106001CCI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "965MXH",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Awendaw, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.