NPIMap

Organization Active NPI

Conway Hospital Community Services

Doing business as CPG Center for Wound Healing

  • Family Medicine Physician
  • Conway, SC
National Provider Identifier
1689928103
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CONWAY HOSPITAL COMMUNITY SERVICES
Doing business as
CPG Center for Wound Healing
Practice address
300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone
(843) 347-8347
Fax
(843) 234-6977
NPI assigned
Nov 6, 2012
Last updated
May 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Authorized official

Name
Mr. Bret A Barr
Title
Cfo
Phone
(843) 347-7111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

300 Singleton Ridge Rd
Conway, SC 29526-9142

Mailing address

PO Box 2180
Conway, SC 29528-2180
Phone (843) 234-5139

Other identifiers 3

IdentifierTypeStateIssuer
7844OtherSCMEDICARE PTAN
DC2203OtherSCRAILROAD MEDICARE GROUP
GP4505MedicaidSC

Other names 1

  • CPG Center for Wound Healing Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040316000313 SC Part B Supplier - Clinic/Group Practice 9830087774 Receives reassigned benefits from 7 practitioners
4 other NPIs on this enrollment
Practice locations: Aynor, SC

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

51 11th Ave
Aynor, SC 29511
Phone (843) 358-3700

204 University Blvd
Conway, SC 29526
Phone (843) 349-2305

2367 Cypress Cir
Ste 200
Conway, SC 29526
Phone (843) 236-2700

4022 Postal Way
Ste B
Myrtle Beach, SC 29579
Phone (843) 903-1010

4887 Socastee Blvd
#9
Myrtle Beach, SC 29588
Phone (843) 293-1005

4999 Carolina Forest Blvd
Ste 9
Myrtle Beach, SC 29579
Phone (843) 236-2700

14 Hwy 17 N
Surfside Beach, SC 29575
Phone (843) 238-5654

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1689928103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2180",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295282180",
            "telephone_number": "843-234-5139",
            "fax_number": "843-234-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-347-8347",
            "fax_number": "843-234-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY HOSPITAL COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "BARR",
        "authorized_official_first_name": "BRET",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "843-347-7111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "7844",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DC2203",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4505",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CPG Center for Wound Healing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.