Southerncare, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

HPC-0078 Issued in SC

Legal business name

SOUTHERNCARE, INC.

Practice address

960 Pamplico Hwy
Suite K
Florence, SC 29505-6244

Phone

(843) 664-9889

Fax

(843) 664-9779

NPI assigned

Jun 6, 2006

Organization subpart

No

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

Authorized official

Name

Jessica Kleberg

Title

VP of Legal Affairs

Phone

(704) 664-2876

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• SouthernCare Florence Doing business as

Locations

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1790724581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 BRAWLEY SCHOOL RD",
            "address_2": "SUITE 200",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179125",
            "telephone_number": "704-664-2876",
            "fax_number": "704-664-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 PAMPLICO HWY",
            "address_2": "SUITE K",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056244",
            "telephone_number": "843-664-9889",
            "fax_number": "843-664-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERNCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "KLEBERG",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "VP OF LEGAL AFFAIRS",
        "authorized_official_telephone_number": "704-664-2876"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "SC",
            "license": "HPC078",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "SC",
            "license": "HPC-0078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP050",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SouthernCare Florence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jefferson Krawulski Souza, CRNA
• Kristen Spang, MS, RDN, LD
• Jeremy Sparkman

• All providers in Florence, SC
• Community Based Hospice Care Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.