NPIMap

Organization Active NPI

St James Health and Wellness Inc

  • Federally Qualified Health Center (FQHC)
  • Andrews, SC
National Provider Identifier
1801219845
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ST JAMES HEALTH AND WELLNESS INC
Practice address
675 North Morgan Avenue
Andrews, SC 29510
Phone
(843) 887-3274
Fax
(843) 887-3817
NPI assigned
Jan 28, 2014
Last updated
Jun 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Authorized official

Name
Sandra D Gilliard
Title
Ceo
Phone
(843) 887-3274

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

675 North Morgan Avenue
Andrews, SC 29510

Mailing address

675 North Morgan Avenue
Andrews, SC 29510
Phone (843) 887-3274

Other names 2

  • St James Santee Family Health Center Former legal business name
  • St. James-Santee Rural Health Program Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140418000377 SC Part A Provider - Federally Qualified Health Center (FQHC) 1658280334 Practice locations: Andrews, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801219845. Details of each certification follow.

Federally qualified health center certification: CCN 421010

Legal name
ST JAMES HEALTH AND WELLNESS INC
Doing business as
ST JAMES SANTEE RURAL HEALTH PROGRAM
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 18, 2014
Last certification
Apr 18, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1981 in SC
Enrollment address
675 North Morgan Avenue
Andrews, SC 29510-9995

Other NPIs with the same Medicare PAC ID 6

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
42D2076025St James-Santee Family Health Cetner, Inc675 North Morgan Avenue, Andrews, SC 29510Provider-performed microscopyApr 9, 2028

National Provider Directory

National Provider Directory
Tax ID family
St James-Santee Family Heal9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

675 N Morgan Ave
Andrews, SC 29510
Phone (843) 264-2680

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
Sandra D. Gilliard Individual Corporate Officer Feb 18, 2014
W-2 Managing EmployeeCeo Feb 18, 2014
Evelyn Grayson Individual Corporate DirectorBoard Member Oct 1, 2023 100%
Joyce Cox Holmes Individual Corporate Director Feb 26, 2014
Hessie Richard Individual 5% Or Greater Indirect Ownership InterestChairman Jan 30, 2024 100%

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.

NPI Registry JSON

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1801219845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 NORTH MORGAN AVENUE",
            "city": "ANDREWS",
            "state": "SC",
            "postal_code": "29510",
            "telephone_number": "843-887-3274",
            "fax_number": "843-887-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 NORTH MORGAN AVENUE",
            "city": "ANDREWS",
            "state": "SC",
            "postal_code": "29510",
            "telephone_number": "843-887-3274",
            "fax_number": "843-887-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JAMES HEALTH AND WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-28",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "GILLIARD",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-887-3274"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St James Santee Family Health Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "St. James-Santee Rural Health Program",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "St. James-Santee Rural Health Program",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Andrews, SC

Sources for this page

Verify at the official NPI Registry.