Organization Active NPI

Carolinas Medical Alliance Inc

  • Internal Medicine Physician
  • Florence, SC
National Provider Identifier
1730147208
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAROLINAS MEDICAL ALLIANCE INC
Practice address
1594 Freedom Blvd
Suite 203
Florence, SC 29505
Phone
(843) 629-7200
NPI assigned
May 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Authorized official

Name
James P Wright
Title
VP Physician Business Services
Phone
(615) 778-1502

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X SC
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X SC Primary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X SC
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X SC

Addresses

Primary practice location

1594 Freedom Blvd
Suite 203
Florence, SC 29505

Mailing address

1594 Freedom Blvd
Suite 203
Florence, SC 29505-6046
Phone (843) 629-7200

Other identifiers 1

IdentifierTypeStateIssuer
GP2829MedicaidSC

National Provider Directory

National Provider Directory

Locations

1594 Freedom Blvd
Ste 203
Florence, SC 29505
Phone (843) 629-7200

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1730147208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1594 FREEDOM BLVD",
            "address_2": "SUITE 203",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056046",
            "telephone_number": "843-629-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1594 FREEDOM BLVD",
            "address_2": "SUITE 203",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29505",
            "telephone_number": "843-629-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINAS MEDICAL ALLIANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VP PHYSICIAN BUSINESS SERVICES",
        "authorized_official_telephone_number": "615-778-1502"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2829",
            "state": "SC"
        }
    ],
    "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 Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.