NPIMap

Organization Active NPI

Sandhills Medical Foundation, Inc.

Doing business as Sandhills Medical Foundation- Pageland

  • Federally Qualified Health Center (FQHC)
  • Pageland, SC
National Provider Identifier
1780398461
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SANDHILLS MEDICAL FOUNDATION, INC.
Doing business as
Sandhills Medical Foundation- Pageland
Practice address
126 N Pearl St
Pageland, SC 29728-1925
Phone
(866) 737-4031
NPI assigned
Jan 9, 2023
Last updated
Sep 29, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SANDHILLS MEDICAL FOUNDATION, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Ernest James-Stanley Wardlaw, CEONPI 1508276528
Title
Ceo
Phone
(803) 900-6614

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

126 N Pearl St
Pageland, SC 29728-1925

Mailing address

PO Box 366
MC Bee, SC 29101-0366
Phone (843) 335-8291

Other names 1

  • Sandhills Medical Foundation- Pageland Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230523003430 SC Part A Provider - Federally Qualified Health Center (FQHC) 8224949821 Practice locations: Pageland, SC
O20240104003460 SC Part B Supplier - Clinic/Group Practice 8224949821 Receives reassigned benefits from 31 practitioners
Practice locations: Pageland, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780398461. Details of each certification follow.

Federally qualified health center certification: CCN 421091

Legal name
SANDHILLS MEDICAL FOUNDATION, INC.
Doing business as
SANDHILLS MEDICAL FOUNDATION-PAGELAND
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 5, 2023
Last certification
Jun 5, 2023
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
May 30, 1977 in SC
Enrollment address
126 N Pearl St
Pageland, SC 29728-1925

Other NPIs with the same Medicare PAC ID 9

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

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
42D2276069Sandhills Medical Foundation - Pageland126 North Pearl Street, Pageland, SC 29728Certificate of waiverFeb 1, 2027

National Provider Directory

National Provider Directory
Part of
Sandhills Med Foundat I

Locations

103 Main St N
Bldg N
Bethune, SC 29009
Phone (843) 334-7145

1165 Highway 1 S
Lugoff, SC 29078
Phone (803) 408-1397

40 Baldwin Ave
Lugoff, SC 29078
Phone (803) 408-3262

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Paul Napper Individual W-2 Managing EmployeeInterim Ceo Oct 9, 2025
Operational/Managerial ControlInterim Ceo Oct 9, 2025
Amanda C Duke Individual W-2 Managing EmployeeCoo Oct 9, 2025
Operational/Managerial ControlCoo Oct 9, 2025

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1780398461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366",
            "city": "MC BEE",
            "state": "SC",
            "postal_code": "291010366",
            "telephone_number": "843-335-8291",
            "fax_number": "843-335-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 N PEARL ST",
            "city": "PAGELAND",
            "state": "SC",
            "postal_code": "297281925",
            "telephone_number": "866-737-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDHILLS MEDICAL FOUNDATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANDHILLS MEDICAL FOUNDATION, INC.",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "WARDLAW",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "JAMES-STANLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-900-6614",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandhills Medical Foundation- Pageland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sandhills Medical Foundation- Pageland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pageland, SC

Sources for this page

Verify at the official NPI Registry.