NPIMap

Organization Active NPI

Carolina Community Care, Inc.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Rock Hill, SC
National Provider Identifier
1801418942
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
CAROLINA COMMUNITY CARE, INC.
Practice address
2275 India Hook Rd
Rock Hill, SC 29732-1223
Phone
(803) 329-1500
Fax
(803) 329-9697
NPI assigned
May 12, 2020
Organization subpart
Yes
Parent organization
CAROLINA COMMUNITY CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Authorized official

Name
Jennifer Graham
Title
Ceo
Phone
(803) 329-1500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X Primary
Community Based Hospice Care Agency 251G00000X

Addresses

Primary practice location

2275 India Hook Rd
Rock Hill, SC 29732-1223

Mailing address

PO Box 993
Rock Hill, SC 29731-6993
Phone (803) 329-1500

Other names 1

  • Hospice & Community Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200604000682 SC Part B Supplier - Clinic/Group Practice 5092891598 Receives reassigned benefits from 4 practitioners
Practice locations: Rock Hill, SC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Carolina Community Care Inc2 organizations share this tax ID, including this one
Part of
Carolina Community Care Inc

Other organizations with this tax ID 1

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

Locations

2275 India Hook Rd
Rock Hill, SC 29732
Phone (803) 329-1500

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Hospice & Community CareRock Hill, SC, CCN 421504 Hospice Operational/Managerial Control Oct 29, 2007

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1801418942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 993",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297316993",
            "telephone_number": "803-329-1500",
            "fax_number": "803-329-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 INDIA HOOK RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321223",
            "telephone_number": "803-329-1500",
            "fax_number": "803-329-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA COMMUNITY CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINA COMMUNITY CARE, INC.",
        "enumeration_date": "2020-05-12",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-329-1500"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice & Community Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hospice & Community Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.