NPIMap

Organization Active NPI

Edisto Regional Health Services Inc.

Doing business as RMC Primary Care North

  • Family Medicine Physician
  • North, SC
National Provider Identifier
1841595667
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EDISTO REGIONAL HEALTH SERVICES INC.
Doing business as
RMC Primary Care North
Practice address
4631 Savannah Highway
North, SC 29112-8180
Phone
(803) 247-2428
Fax
(803) 247-2650
NPI assigned
Jan 26, 2011
Last updated
Sep 28, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
EDISTO REGIONAL HEALTH SERVICES INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

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

Authorized official

Name
Liza Porterfield
Title
C F O
Phone
(803) 395-4458

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X SC
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

4631 Savannah Highway
North, SC 29112-8180

Mailing address

PO Box 1245
Orangeburg, SC 29116-1245
Phone (803) 395-4762

Other identifiers 7

IdentifierTypeStateIssuer
009OtherSCTRICARE
CN8991OtherSCRRMEDICARE
GP44779MedicaidSC
42-3881OtherSCRHC MEDICAID
009OtherSCBLUECHOICE
009OtherSCBCBS
CK8831OtherSCRRMEDICARE

Other names 1

  • RMC Primary Care North Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040810000307 SC Part B Supplier - Clinic/Group Practice 4981693447 Receives reassigned benefits from 41 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bowman, SC; Bamberg, SC; Santee, SC; Saint Matthews, SC; Orangeburg, SC; Holly Hill, SC; Branchville, SC

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Part of
SC Orthopaedic Institute

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506556800000",
    "number": "1841595667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291161245",
            "telephone_number": "803-395-4762",
            "fax_number": "803-536-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 SAVANNAH HIGHWAY",
            "city": "NORTH",
            "state": "SC",
            "postal_code": "291128180",
            "telephone_number": "803-247-2428",
            "fax_number": "803-247-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISTO REGIONAL HEALTH SERVICES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDISTO REGIONAL HEALTH SERVICES INC.",
        "enumeration_date": "2011-01-26",
        "last_updated": "2017-09-28",
        "status": "A",
        "authorized_official_last_name": "PORTERFIELD",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "C F O",
        "authorized_official_telephone_number": "803-395-4458"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "009",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "CN8991",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP44779",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHC MEDICAID",
            "identifier": "42-3881",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE",
            "identifier": "009",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "009",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE",
            "identifier": "CK8831",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RMC Primary Care North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; 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.