NPIMap

Organization Active NPI

Medical University Hospital Authority

Doing business as MUSC Health Lowry's Primary Care

  • Rural Health Clinic/Center
  • Chester, SC
National Provider Identifier
1790394203
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MEDICAL UNIVERSITY HOSPITAL AUTHORITY
Doing business as
MUSC Health Lowry's Primary Care
Practice address
517 Doctors CT
Chester, SC 29706-8644
Phone
(803) 581-2800
NPI assigned
Jul 30, 2020
Last updated
Sep 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Authorized official

Name
Karyn Rae
Title
Chief
Phone
(843) 876-1344

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

517 Doctors CT
Chester, SC 29706-8644

Mailing address

PO Box 23467
New York, NY 10087-3467
Phone (843) 792-6200

Other names 1

  • MUSC Health Lowry's Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201215002810 SC Part A Provider - Rural Health Clinic 1557268950 Practice locations: Chester, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790394203. Details of each certification follow.

Rural health clinic certification: CCN 423481

Legal name
MEDICAL UNIVERSITY HOSPITAL AUTHORITY
Doing business as
MUSC HEALTH LOWRY'S PRIMARY CARE CHESTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 19, 2021
Last certification
May 8, 2024
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
517 Doctors CT
Chester, SC 29706-8644
Related CCNs
420019

Facilities connected through Provider of Services related, parent or unit certification numbers.

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
42D0882802Medical University Hospital Authority Dba517 Doctors Court, Chester, SC 29706Certificate of waiverJul 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Musc Hospital71 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Lisa M Goodlett Individual Corporate OfficerCeo Mar 1, 2019
Sonya Floyd Individual W-2 Managing Employee Mar 12, 2019
Karyn Rae Individual Corporate Director Mar 12, 2019
Patrick J Cawley Individual Corporate OfficerCeo Mar 1, 2019

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tidelands Waccamaw Community HospitalMurrells Inlet, SC, CCN 420098 Hospital Operational/Managerial Control Oct 1, 2025
Tidelands Georgetown Memorial HospitalGeorgetown, SC, CCN 420020 Hospital Operational/Managerial Control Oct 1, 2025
Musc Health Lancaster Medical CenterLancaster, SC, CCN 429803 Hospital Operational/Managerial Control (100%) Mar 1, 2019
Musc Health Lancaster Rehabilitation CenterLancaster, SC, CCN 42T036 Hospital Operational/Managerial Control (100%) Mar 1, 2019
Tidelands Georgetown Memorial HospitalGeorgetown, SC, CCN 42U020 Hospital Operational/Managerial Control Oct 1, 2025
Tidelands Health Family Medicine at GeorgetownGeorgetown, SC, CCN 428958 Rural health clinic Operational/Managerial Control Oct 1, 2020
Tidelands Health Family Medicine at HemingwayHemingway, SC, CCN 423859 Rural health clinic Operational/Managerial Control Oct 1, 2025
Tidelands Health Family MedicineAndrews, SC, CCN 423970 Rural health clinic Operational/Managerial Control Oct 1, 2025
Tidelands Health Family Medicine at Pawleys IslandPawleys Island, SC, CCN 423870 Rural health clinic Operational/Managerial Control Oct 1, 2025
Musc Health Primary Care - Thurgood Marshall BlvdKingstree, SC, CCN 423448 Rural health clinic Operational/Managerial Control (100%) Dec 1, 2022
Musc Community PhysiciansBranchville, SC, CCN 423856 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2021

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1790394203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23467",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873467",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 DOCTORS CT",
            "city": "CHESTER",
            "state": "SC",
            "postal_code": "297068644",
            "telephone_number": "803-581-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL UNIVERSITY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "RAE",
        "authorized_official_first_name": "KARYN",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "843-876-1344"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MUSC Health Lowry's Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MUSC Health Lowry's Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chester, SC

Sources for this page

Verify at the official NPI Registry.