NPIMap

Organization Active NPI

Eau Claire Cooperative Health Center, Inc.

  • Community Health Clinic/Center
  • Hopkins, SC
National Provider Identifier
1902176183
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Practice address
9023 Garners Ferry Rd
Hopkins, SC 29061-9540
Phone
(803) 978-1848
Fax
(803) 978-1852
NPI assigned
Jan 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Authorized official

Name
Kimberly M Tilley
Title
Credentialing Manager
Phone
(804) 306-1203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

9023 Garners Ferry Rd
Hopkins, SC 29061-9540

Mailing address

PO Box 3788
Columbia, SC 29230-3788
Phone (803) 753-5591

Other identifiers 3

IdentifierTypeStateIssuer
CBP018MedicaidSC
FQC031MedicaidSC
FQC152MedicaidSC

Other names 1

  • Hopkins Pediatrics and Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040114000335 SC Part B Supplier - Clinic/Group Practice 3274434220 Receives reassigned benefits from 153 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, SC; Eastover, SC; Hopkins, SC; Jenkinsville, SC; Leesville, SC; Little Mountain, SC; Newberry, SC; Pelion, SC…
O20121030000274 SC Part A Provider - Federally Qualified Health Center (FQHC) 3274434220 Practice locations: Hopkins, SC

Federally qualified health center certification: CCN 421979

Legal name
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Doing business as
HOPKINS PEDIATRICS AND FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 30, 2012
Last certification
Oct 30, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 14, 1992 in SC
Enrollment address
9023 Garners Ferry Rd
Hopkins, SC 29061-9687

Other NPIs on the same Medicare enrollment 23

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

View all 23

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2035729Hopkins Family Practice9023 Garners Ferry Road, Hopkins, SC 29061Provider-performed microscopyJan 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
Eau Claire Cooperative Health Center Inc42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Karena S White Individual W-2 Managing Employee Mar 7, 2022
Junior Delgado Cantave Individual Corporate Director Sep 28, 2016
W-2 Managing Employee Sep 28, 2016

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Eau Claire Cooperative Health Center, Inc.Columbia, SC, CCN 421843 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2019
Eastover Family PracticeEastover, SC, CCN 421960 Federally qualified health center Operational/Managerial Control Jan 26, 2012
Pediatrics of NewberryNewberry, SC, CCN 421970 Federally qualified health center 5% Or Greater Direct Ownership Interest Jul 1, 2014
Waverly Women'S Health & Internal MedicineBatesburg Leesville, SC, CCN 421974 Federally qualified health center 5% Or Greater Direct Ownership Interest Jun 1, 2010
Eau Claire PodiatryColumbia, SC, CCN 421968 Federally qualified health center 5% Or Greater Direct Ownership Interest Mar 7, 2022
Sterling Sharpe PediatricsSuite 1, SC, CCN 421972 Federally qualified health center 5% Or Greater Direct Ownership Interest Nov 4, 2014
Pelion Pediatrics Family & DentalPelion, SC, CCN 421977 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 19, 2012
Brookland Community PediatricsWest Columbia, SC, CCN 421978 Federally qualified health center 5% Or Greater Direct Ownership Interest Jul 1, 2010
Pediatrics of Batesburg-LeesburgBatesburg-Leesville, SC, CCN 421980 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 30, 2012
Eau Claire Walk-inColumbia, SC, CCN 421023 Federally qualified health center 5% Or Greater Direct Ownership Interest Mar 7, 2022
Five Points Behavioral Health at Hand Middle SchoolColumbia, SC, CCN 421064 Federally qualified health center Operational/Managerial Control Jan 1, 2016
Eau Claire Cooperative Health Center, Inc.Little Mountain, SC, CCN 421068 Federally qualified health center Operational/Managerial Control Jan 1, 2016
Columbia Community Family PracticeColumbia, SC, CCN 871035 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2016
Advantage Eye CareColumbia, SC, CCN 871038 Federally qualified health center 5% Or Greater Direct Ownership Interest Jun 1, 2022

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782259200000",
    "number": "1902176183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3788",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292303788",
            "telephone_number": "803-753-5591",
            "fax_number": "803-753-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9023 GARNERS FERRY RD",
            "city": "HOPKINS",
            "state": "SC",
            "postal_code": "290619540",
            "telephone_number": "803-978-1848",
            "fax_number": "803-978-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-05",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A",
        "authorized_official_last_name": "TILLEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "804-306-1203"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CBP018",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FQC031",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FQC152",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hopkins Pediatrics and Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hopkins, SC

Sources for this page

Verify at the official NPI Registry.