Active NPI
Tandem Health SC
- Federally Qualified Health Center (FQHC)
- Sumter, SC
National Provider Identifier
1649035841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- TANDEM HEALTH SC
- Practice address
- 425 N. Salem Avenue
Sumter, SC 29150-4115 - Phone
- (803) 774-4500
- Fax
- (803) 774-4627
- NPI assigned
- Feb 16, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Annie Brown
- Title
- Ceo
- Phone
- (803) 774-4545
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary |
Addresses
Primary practice location
425 N. Salem Avenue
Sumter, SC 29150-4115
Mailing address
Tandem Health SC
550 S Pike West
Sumter, SC 29150-2616
Phone (803) 324-6975
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FQC308 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241008000887 | SC | Part A Provider - Federally Qualified Health Center (FQHC) | 3870575855 | Practice locations: Sumter, SC |
| O20241111000490 | SC | Part B Supplier - Clinic/Group Practice | 3870575855 |
Receives reassigned benefits from 17 practitioners Practice locations: Sumter, SC |
Federally qualified health center certification: CCN 421102
- Legal name
- TANDEM HEALTH SC
- Doing business as
- TANDEM HEALTH SC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 1, 2024
- Last certification
- Jul 1, 2024
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Mar 30, 1999 in SC
- Enrollment address
- 425 N Salem Ave
Sumter, SC 29150-4115
Other NPIs with the same Medicare PAC ID 9
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D2302250 | Tandem Health | Provider-performed microscopy | Apr 7, 2028 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 15
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Annie Brown | Corporate Officer | Mar 30, 1999 | |
| W-2 Managing Employee | Mar 30, 1999 | ||
| Ashlynd Buchanan | Corporate Director | Apr 1, 2026 | |
| Courtney D Butts | Corporate Director | Apr 1, 2026 | |
| Heidi M Adler | Corporate Director | Apr 8, 2021 | |
| Terrance L Dupree | Corporate Director | Dec 4, 2023 | |
| Linda L Jackson | Corporate Director | Apr 22, 2025 | |
| Melanie D Stokes-Dees | Corporate Director | Apr 1, 2026 | |
| Lydia J Woods-Johnson | Corporate Director | Apr 19, 2021 | |
| Joy Lawson | Corporate Director | Apr 7, 2023 | |
| Jodi L Robbins | Corporate Director | Apr 7, 2023 | |
| Shauna K Larson | Corporate Director | Apr 1, 2026 | |
| Hether H Enzor | Corporate Director | Apr 7, 2023 | |
| Glenn T Rivers | Corporate Director | Apr 1, 2026 | |
| Tracey Denise Flemming | Corporate Director | Apr 22, 2025 | |
| Keishan M Scott | Corporate Director | Apr 1, 2026 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Emergency Medicine Physician
- Sumter, SC
- NPI 1700932951
Corporate Director
Practitioners & affiliated clinicians
Practitioners 35
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Sumter, SC
- NPI 1346004215
SC
-
- Psychiatric/Mental Health Nurse Practitioner
- Moncks Corner, SC
- NPI 1194215798
SC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708041600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728432000000",
"number": "1649035841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "TANDEM HEALTH SC",
"address_2": "550 S PIKE WEST",
"city": "SUMTER",
"state": "SC",
"postal_code": "291502616",
"telephone_number": "803-324-6975",
"fax_number": "803-324-6975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 N. SALEM AVENUE",
"city": "SUMTER",
"state": "SC",
"postal_code": "291504115",
"telephone_number": "803-774-4500",
"fax_number": "803-774-4627"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TANDEM HEALTH SC",
"organizational_subpart": "NO",
"enumeration_date": "2024-02-16",
"last_updated": "2024-10-09",
"status": "A",
"authorized_official_last_name": "BROWN",
"authorized_official_first_name": "ANNIE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "803-774-4545",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FQC308",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sumter, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.