NPIMap

Organization Active NPI

Carolina Rural Practice Management, Inc.

  • Rural Health Clinic/Center
  • Wagener, SC
National Provider Identifier
1811020183
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
08504 Issued in SC
Legal business name
CAROLINA RURAL PRACTICE MANAGEMENT, INC.
Practice address
120 Louie Street
Wagener, SC 29164-0098
Phone
(803) 564-6497
Fax
(803) 564-6498
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
Mr. Charlie Clifton Alsbrooks
Title
Administrator
Phone
(803) 641-6277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 08504 SC Primary

Addresses

Primary practice location

120 Louie Street
Wagener, SC 29164-0098

Mailing address

PO Box 98
120 Louie St
Wagener, SC 29164-0098
Phone (803) 564-6497

Other identifiers 1

IdentifierTypeStateIssuer
RHC025MedicaidSC

Other names 1

  • Wagener Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Carolina Rural Practice Management Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1811020183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "address_2": "120 LOUIE ST",
            "city": "WAGENER",
            "state": "SC",
            "postal_code": "291640098",
            "telephone_number": "803-564-6497",
            "fax_number": "803-564-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LOUIE STREET",
            "city": "WAGENER",
            "state": "SC",
            "postal_code": "291640098",
            "telephone_number": "803-564-6497",
            "fax_number": "803-564-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA RURAL PRACTICE MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "ALSBROOKS",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_middle_name": "CLIFTON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "803-641-6277",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SC",
            "license": "08504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHC025",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wagener Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wagener, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.