NPIMap

Organization Active NPI

Onsite Home Primary Care

  • Family Medicine Physician
  • Easley, SC
National Provider Identifier
1730966110
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ONSITE HOME PRIMARY CARE
Practice address
105 Franklin Square Way Ste a
Easley, SC 29642-3715
Phone
(864) 442-4110
Fax
(864) 442-4126
NPI assigned
Sep 11, 2023
Last updated
Oct 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Joel Childers
Title
Coo
Phone
(803) 341-4101

Specialties & licenses 1

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

Addresses

Primary practice location

105 Franklin Square Way Ste a
Easley, SC 29642-3715

Mailing address

105 Franklin Square Way Ste a
Easley, SC 29642-3715
Phone (864) 442-4110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231121000595 SC Part B Supplier - Clinic/Group Practice 6204284839 Receives reassigned benefits from 10 practitioners
Practice locations: Easley, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1730966110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 FRANKLIN SQUARE WAY STE A",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423715",
            "telephone_number": "864-442-4110",
            "fax_number": "864-442-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 FRANKLIN SQUARE WAY STE A",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296423715",
            "telephone_number": "864-442-4110",
            "fax_number": "864-442-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONSITE HOME PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "803-341-4101"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.