NPIMap

Organization Active NPI

State of South Carolina

  • Home Health Agency
  • Florence, SC
National Provider Identifier
1891713723
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA-009 Issued in SC
Legal business name
STATE OF SOUTH CAROLINA
Practice address
1705 W Evans St
Florence, SC 29501-3331
Phone
(843) 661-4762
Fax
(843) 661-4790
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Authorized official

Name
Mr. Lee A Kirkpatrick, LMSW
Title
Director/Home Health Administrator
Phone
(803) 576-2916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA-009 SC Primary

Addresses

Primary practice location

1705 W Evans St
Florence, SC 29501-3331

Mailing address

1705 W Evans St
Florence, SC 29501-3331
Phone (843) 661-4762

Other identifiers 3

IdentifierTypeStateIssuer
395450MedicaidSC
153550OtherSCUNISON HEALTH PLAN OF SC
20021671OtherSCSELECT HEALTH PROVIDER

Other names 1

  • SC DHEC Pee Dee Home Health Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Tax ID family
Capital Care Resources of South Carolina LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2016 Change of OwnershipThis provider was the seller Centerwell Home HealthCCN 427854, SC, NPI 1528433521

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373500800000",
    "number": "1891713723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 W EVANS ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013331",
            "telephone_number": "843-661-4762",
            "fax_number": "843-661-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 W EVANS ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013331",
            "telephone_number": "843-661-4762",
            "fax_number": "843-661-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF SOUTH CAROLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2013-07-11",
        "status": "A",
        "authorized_official_last_name": "KIRKPATRICK",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR/HOME HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "803-576-2916",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SC",
            "license": "HHA-009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395450",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON HEALTH PLAN OF SC",
            "identifier": "153550",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH PROVIDER",
            "identifier": "20021671",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SC DHEC Pee Dee Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.