NPIMap

Organization Active NPI

Conway Hospital Inc

Doing business as CMC Primary Care-Bell Street

  • Family Nurse Practitioner
  • Conway, SC
National Provider Identifier
1780995373
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
CONWAY HOSPITAL INC
Doing business as
CMC Primary Care-Bell Street
Practice address
903 Bell St
Conway, SC 29526-4113
Phone
(843) 488-2111
Fax
(843) 488-2112
NPI assigned
Jun 29, 2010
Last updated
Aug 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Authorized official

Name
Mary Ellen Artioli
Title
Credentialing Specialist
Phone
(843) 234-6946

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

903 Bell St
Conway, SC 29526-4113

Mailing address

300 Singleton Ridge Rd
Attn: Patient Accounting
Conway, SC 29526-9142
Phone (843) 234-6946

Other identifiers 1

IdentifierTypeStateIssuer
GP4505MedicaidSC

Other names 3

  • CMC PRIMARY CARE-BELL STREET Doing business as
  • CONWAY HOSPITAL COMMUNITY SERVICES Former legal business name
  • CPG FAMILY MEDICINE BELL STREET Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000111 SC Part B Supplier - Clinic/Group Practice 7113839606 Receives reassigned benefits from 148 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Conway, SC; Surfside Beach, SC; Myrtle Beach, SC; Murrells Inlet, SC; Little River, SC; Florence, SC

Other NPIs on the same Medicare enrollment 40

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 40

National Provider Directory

National Provider Directory

Locations

903 Bell St
Conway, SC 29526
Phone (843) 248-7568

Practitioners & affiliated clinicians

Practitioners 1

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.

  • Aditya Sood, MD
    • Cardiovascular Disease Physician
    • Conway, SC
    • NPI 1871934448

    Multi-Specialty

    NPD

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1780995373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTN: PATIENT ACCOUNTING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946",
            "fax_number": "843-234-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 BELL ST",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295264113",
            "telephone_number": "843-488-2111",
            "fax_number": "843-488-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-29",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A",
        "authorized_official_last_name": "ARTIOLI",
        "authorized_official_first_name": "MARY ELLEN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "843-234-6946"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4505",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMC PRIMARY CARE-BELL STREET",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CONWAY HOSPITAL COMMUNITY SERVICES",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "CPG FAMILY MEDICINE BELL STREET",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Conway, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.