NPIMap

Organization Active NPI

Carolina Children'S Clinic, LLC

  • Urgent Care Clinic/Center
  • Boiling Springs, SC
National Provider Identifier
1649915216
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CAROLINA CHILDREN'S CLINIC, LLC
Practice address
316 Village Creek Dr
Boiling Springs, SC 29316-5387
Phone
(864) 327-9003
NPI assigned
Apr 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
David 'Carson' Moore
Title
Owner/Authorized Official
Phone
(843) 324-7575

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

316 Village Creek Dr
Boiling Springs, SC 29316-5387

Mailing address

316 Village Creek Dr
Boiling Springs, SC 29316-5387
Phone (864) 327-9003

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
42D2269731Carolina Children'S Clinic316 Village Creek Drive, Boiling Springs, SC 29316Certificate of waiverOct 2, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1651104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1649915216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 VILLAGE CREEK DR",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293165387",
            "telephone_number": "864-327-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 VILLAGE CREEK DR",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293165387",
            "telephone_number": "864-327-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA CHILDREN'S CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-28",
        "last_updated": "2023-01-30",
        "certification_date": "2022-10-30",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "DAVID 'CARSON'",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "843-324-7575"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boiling Springs, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.