Full Circle Health LLC – Family Nurse Practitioner

Key facts

NPI: 1649029067
Entity type: Organization (NPI type 2)
Primary specialty: Family Nurse Practitioner 363LF0000X
Legal business name: FULL CIRCLE HEALTH LLC
Practice address: 1119 Pepper Ridge Dr
Lugoff, SC 29078-9655
Phone: (803) 669-5616
NPI assigned: May 17, 2024
Organization subpart: No

Authorized official

Name: Mrs. Christa Campbell Boss, FNP NPI 1174854889
Title: Owner/Provider
Phone: (803) 669-5616

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

Practitioners 1

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

Christa Campbell Boss, FNP Family Nurse Practitioner · Lugoff, SC · NPI 1174854889

Medicare reassignment NPD Authorized official FAMILY · SC

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
42D2309854	Full Circle Health, LLC 1119 Pepper Ridge Drive, Lugoff, SC 29078	Certificate of waiver	Aug 21, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in SC

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20240531001398	SC	Part B Supplier - Clinic/Group Practice	6103268446	Receives reassigned benefits from 1 practitioner Practice locations: Lugoff, SC

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner Group: 193400000X SINGLE SPECIALTY GROUP	363LF0000X			Yes

Addresses

Primary practice location

1119 Pepper Ridge Dr
Lugoff, SC 29078-9655

Mailing address

1119 Pepper Ridge Dr
Lugoff, SC 29078-9655
Phone (803) 669-5616

Other providers in Lugoff, SC

Karla De Leon Mendez
Doctors Care SC, PA
Janaki Lakshmi Emani, M.D.
Fresenius Medical Care Cna Kidney Centers, LLC
Valerie Alison Fritsch, M.D.
Susan Floyd Gregory, DMD
Maria E Guilhamelou
Rachel Kara Gunter-Garcia, LMSW
James Levi Hall, LPCA
Mandi Hamilton, PTA

All providers in Lugoff, SC · Family Nurse Practitioner 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 May 17, 2024. 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.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.