Sandhills Medical Foundation, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Pageland, SC
NPI 1780398461 · NPPES record last updated Sep 29, 2023
Key facts
- NPI
- 1780398461
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- SANDHILLS MEDICAL FOUNDATION, INC.
- Practice address
- 126 N Pearl St
Pageland, SC 29728-1925 - Phone
- (866) 737-4031
- NPI assigned
- Jan 9, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- SANDHILLS MEDICAL FOUNDATION, INC.
Authorized official
- Name
- Ernest James-Stanley Wardlaw, CEO
- Title
- Ceo
- Phone
- (803) 900-6614
Other NPIs with the same Medicare PAC ID 9
Practitioners 45
-
Woodrow Anthony Bell, M.D.
-
Geneva Bradshaw, LPCC
-
Karen Elaine Clyburn, APRN
-
Lisa D Clyburn, NP-C
-
Alfred R Frye, DO
-
Allison Kazue Hamada, M.D.
-
Deidre J Hudson, MD
-
Anna Maria Lee, M.S.S.W
-
Latyce Kalynn Locker, MA, LPC, LAC, AADC
-
Morgan Lane Magee, APRN FNP
-
Angela S. Mearns, FNP
-
Kelly Michele Myers, FNP-C
-
Ayodele A Ogunfowora, M.D.
-
Akinwale Olayinka Olatosi, M.B.B.S
-
Quintella Anartica Riley, APRN
-
David E Thompson, NP
-
William Lee Wagers, D.C.
-
Lisa Leigh Corum, MD
-
Nigel E. Taylor, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D2276069 | Sandhills Medical Foundation - Pageland | Certificate of waiver | Feb 1, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SC
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
- Other · Non-profit
- Incorporated
- May 30, 1977 in SC
- Enrollment address
- 126 N Pearl St
Pageland, SC 29728-1925
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Paul Napper |
W-2 Managing Employee |
Oct 9, 2025 | |
| Operational/Managerial Control |
Oct 9, 2025 | ||
| Amanda C Duke |
W-2 Managing Employee |
Oct 9, 2025 | |
| Operational/Managerial Control |
Oct 9, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Part of
- Sandhills Medical Foundation Inc
Locations
103 Main St N
Bldg N
Bethune, SC 29009
Phone (843) 334-7145
727 S Seventh St
Mc Bee, SC 29101
Phone (843) 335-8291
6 Barnette Dr
Sumter, SC 29150
Phone (803) 773-3391
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
- Sandhills Medical Foundation- Pageland
Other providers in Pageland, SC
- Poplar Springs Assisted Living
- Charles T. Powell Jr.
- Cashion Rivers
- Ashley Robinson
- Sandhills Medical Foundation, Inc
- Sonya C Sims
- South Carolina CVS Pharmacy LLC
- Southern Charm Medical and Wellness, LLC
- Strickland Cares
- Dajuan J Strickland
All providers in Pageland, SC · Federally Qualified Health Center (FQHC) in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.