NPIMap

Organization Active NPI

Carolina Family Care Inc

Doing business as MUSC Physicians PCP James Island

  • Internal Medicine Physician
  • Charleston, SC
National Provider Identifier
1821029646
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
75-17508 Issued in SC
Legal business name
CAROLINA FAMILY CARE INC
Doing business as
MUSC Physicians PCP James Island
Practice address
490 Martello Dr
Charleston, SC 29412-2638
Phone
(843) 762-5480
NPI assigned
Jul 6, 2006
Last updated
Jan 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Authorized official

Name
Karyn Rae
Title
Manager
Phone
(843) 876-1344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 75-17508 SC Primary

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 1

  • MUSC Physicians PCP James Island Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory

Locations

30 Bee St
#2100
Charleston, SC 29403
Phone (843) 792-6500

490 Martello Dr
Charleston, SC 29412
Phone (843) 762-4963

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1821029646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602108",
            "telephone_number": "843-762-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 MARTELLO DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122638",
            "telephone_number": "843-762-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA FAMILY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "RAE",
        "authorized_official_first_name": "KARYN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "843-876-1344"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "75-17508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MUSC Physicians PCP James Island",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MUSC Physicians PCP James Island",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.