NPIMap

St Josephs Candler Urgent Care Centers LLC

Organization Active NPI Urgent Care Clinic/Center · Bluffton, SC

NPI 1902468697 · NPPES record last updated Jul 2, 2019

Key facts

NPI
1902468697
Entity type
Organization (NPI type 2)
Primary specialty
Urgent Care Clinic/Center 261QU0200X
Legal business name
ST JOSEPHS CANDLER URGENT CARE CENTERS LLC
Practice address
3 Progressive St
Bluffton, SC 29910-5165
Phone
(843) 548-0533
Fax
(843) 815-9121
NPI assigned
Jul 2, 2019
Organization subpart
No

Authorized official

Name
Tamara White
Title
VP, Rev Cycle Services
Phone
(225) 214-1031

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 114

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

View all 114

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190703000534 SC DME Supplier - Multi-Specialty - Physician 5092058016 Practice locations: Bluffton, SC

National Provider Directory

Locations

64 Oracal Pkwy
Bldg 1
Ellabell, GA 31308
Phone (912) 214-7920

13314 Highway 144
Ste C
Richmond Hill, GA 31324
Phone (912) 910-2010

5621 Highway 21 S
Rincon, GA 31326
Phone (912) 295-5860

3 Progressive St
Bluffton, SC 29910
Phone (843) 548-0533

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Yes

Addresses

Primary practice location

3 Progressive St
Bluffton, SC 29910-5165

Mailing address

P.O. Box 415000
MSC 8071
Nashville, TN 37241-8071
Phone (843) 548-0533

Other identifiers

IdentifierTypeStateIssuer
GP8810MedicaidSC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 2, 2019.

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1902468697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 415000",
            "address_2": "MSC 8071",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372418071",
            "telephone_number": "843-548-0533",
            "fax_number": "843-815-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PROGRESSIVE ST",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299105165",
            "telephone_number": "843-548-0533",
            "fax_number": "843-815-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPHS CANDLER URGENT CARE CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "VP, REV CYCLE SERVICES",
        "authorized_official_telephone_number": "225-214-1031"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP8810",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

All providers in Bluffton, SC · Urgent Care Clinic/Center in South Carolina

Sources for this page

Verify at the official NPI Registry.