Carolina Family Care Inc
Organization Active NPI Internal Medicine Physician · Charleston, SC
NPI 1821029646 · NPPES record last updated Jan 9, 2019
Key facts
- NPI
- 1821029646
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 75-17508 (SC)
- Legal business name
- CAROLINA FAMILY CARE INC
- Practice address
- 490 Martello Dr
Charleston, SC 29412-2638 - Phone
- (843) 762-5480
- NPI assigned
- Jul 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Karyn Rae
- Title
- Manager
- Phone
- (843) 876-1344
Other NPIs on the same Medicare enrollment 15
Practitioners 12
-
Kathy Bolus, MD
-
Shannon Williamson Cribb, APRN NP-C
-
Justin William Dean, M.D.
-
Edward Gilbreth, MD
-
Jameela Sherene Goudarzi, NURSE PRACTITIONER
-
Anemaria Lutas, MD
-
Katherine Pfeninger, APRN
-
Lauren Nickels Turner, FNP-BC
-
Brian M Ely, DO
-
Jon Martin McGough, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040203000627 | SC | Part B Supplier - Clinic/Group Practice | 4587557731 |
Receives reassigned benefits from 540 practitioners 15 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mount Pleasant, SC; Mt Pleasant, SC; Summerville, SC; Charleston, SC; Daniel Island, SC; Johns Island, SC; Moncks Corner, SC; Florence, SC |
National Provider Directory
Locations
30 Bee St
Ste 2100
Charleston, SC 29403
Phone (843) 792-6500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 75-17508 | SC | Yes |
Addresses
Primary practice location
490 Martello Dr
Charleston, SC 29412-2638
Mailing address
PO Box 602108
Charlotte, NC 28260-2108
Phone (843) 762-5480
Other names
- MUSC Physicians PCP James Island
Other providers in Charleston, SC
- Carolina Eyes
- Carolina Family Care
- Carolina Family Care
- Carolina Family Care Inc
- Carolina Family Care Inc
- Carolina Family Care, Inc
- Carolina Family Care, Inc
- Carolina Family Care, Inc
- Carolina Family Care, Inc
- Carolina Foot & Ankle Specialists, LLC
All providers in Charleston, SC · Internal Medicine Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.