Organization Active NPI

Carolina Medical Consultants PA

  • Primary Care Clinic/Center
  • Rock Hill, SC
National Provider Identifier
1760577837
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CAROLINA MEDICAL CONSULTANTS PA
Practice address
311 Glenwood Dr
Rock Hill, SC 29732-1818
Phone
(803) 366-7175
NPI assigned
Oct 4, 2006
Last updated
Dec 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Authorized official

Name
David Jenkins, M.D.
Title
President
Phone
(803) 366-7175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X SC Primary

Addresses

Primary practice location

311 Glenwood Dr
Rock Hill, SC 29732-1818

Mailing address

311 Glenwood Dr
Rock Hill, SC 29732-1818
Phone (803) 366-7175

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000177 SC Part B Supplier - Clinic/Group Practice 0941106066 Receives reassigned benefits from 6 practitioners
Practice locations: Rock Hill, SC

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
42D0253501Carolina Medical Consultants/Piedmont Physician311 Glenwood Drive, Rock Hill, SC 29732Certificate of waiverJan 12, 2027

National Provider Directory

National Provider Directory

Locations

311 Glenwood Dr
Rock Hill, SC 29732
Phone (803) 366-7175

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22888/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325203200000",
    "number": "1760577837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 GLENWOOD DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321818",
            "telephone_number": "803-366-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 GLENWOOD DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321818",
            "telephone_number": "803-366-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA MEDICAL CONSULTANTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-12-30",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-366-7175",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.