NPIMap

Organization Active NPI

Eastern Carolina Family Medicine

  • Specialist
  • Florence, SC
National Provider Identifier
1669423364
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
EASTERN CAROLINA FAMILY MEDICINE
Practice address
3124 S Cashua Dr
Florence, SC 29501-6302
Phone
(843) 665-2600
Fax
(843) 665-7530
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Authorized official

Name
Mrs. Teresa Evans
Title
Office Manager
Phone
(843) 665-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3124 S Cashua Dr
Florence, SC 29501-6302

Mailing address

PO Box 5357
Florence, SC 29502-5357
Phone (843) 665-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040204000781 SC Part B Supplier - Clinic/Group Practice 6901799873 Receives reassigned benefits from 2 practitioners
Practice locations: Florence, SC

National Provider Directory

National Provider Directory

Locations

3124 S Cashua Dr
Florence, SC 29501
Phone (843) 665-2600

Practitioners & affiliated clinicians

Practitioners 6

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": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1669423364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5357",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295025357",
            "telephone_number": "843-665-2600",
            "fax_number": "843-665-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 S CASHUA DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295016302",
            "telephone_number": "843-665-2600",
            "fax_number": "843-665-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN CAROLINA FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-665-2600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Sep 22, 2010; 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.