South Carolina PHS PC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

SOUTH CAROLINA PHS PC

Practice address

6650 Rivers Ave
North Charleston, SC 29406-4809

Phone

(877) 260-4747

NPI assigned

Jan 28, 2011

Last updated

Jul 2, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

PROVIDER HEALTH SERVICES LLCAs reported in NPPES

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

Authorized official

Name

Nicole Howard

Title

Cfo

Phone

(337) 991-9276

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1821394438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 DULLES DRIVE",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70506",
            "telephone_number": "337-991-9276",
            "fax_number": "337-991-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6650 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294064809",
            "telephone_number": "877-260-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA PHS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDER HEALTH SERVICES LLC",
        "enumeration_date": "2011-01-28",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "337-991-9276"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5622",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Carolina CVS Pharmacy LLC (CVS Pharmacy #16950)
• South Carolina CVS Pharmacy LLC (CVS Pharmacy #03977)
• South Carolina CVS Pharmacy, L.L.C. (CVS Pharmacy # 00626)
• South Carolina Dept of Mental Health Accounting Office (Tricounty Crisis Stabilization Center)
• South Carolina Dhec (Diabetes Education Program Trident)
• Terri Southard, MS, LPC
• Bonita A Spade, FNP,CDE
• Jennifer Kirby Spaker, RN
• Frank Carl Sparacino, D.D.S.
• Spark Your Speech LLC

• Nurse Practitioner in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.