Active NPI
Benjamin Bowles
- Assisted Living Facility
- MC Clellanville, SC
National Provider Identifier
1851978605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- CRC-0090
- Practice address
- 9270 N Highway 17
MC Clellanville, SC 29458-9422 - Phone
- (843) 887-4180
- Fax
- (843) 865-1431
- NPI assigned
- Mar 26, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | CRC-0090 | SC | Primary |
Addresses
Primary practice location
9270 N Highway 17
MC Clellanville, SC 29458-9422
Mailing address
9270 N Highway 17
MC Clellanville, SC 29458-9422
Phone (843) 887-4180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CRC-0090 | SC | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619049600000",
"number": "1851978605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9270 N HIGHWAY 17",
"city": "MC CLELLANVILLE",
"state": "SC",
"postal_code": "294589422",
"telephone_number": "843-887-4180",
"fax_number": "843-865-1431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9270 N HIGHWAY 17",
"city": "MC CLELLANVILLE",
"state": "SC",
"postal_code": "294589422",
"telephone_number": "843-887-4180",
"fax_number": "843-865-1431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWLES",
"first_name": "BENJAMIN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-26",
"last_updated": "2021-04-22",
"certification_date": "2021-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "SC",
"license": "CRC-0090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in MC Clellanville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.