NPIMap

Organization Active NPI

Hopeclinic Walterboro

  • Clinic/Center
  • Walterboro, SC
National Provider Identifier
1912967290
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
20234 Issued in SC
Legal business name
HOPECLINIC WALTERBORO
Practice address
211 Eddie Chasteen Dr
Walterboro, SC 29488-5728
Phone
(843) 549-9200
Fax
(843) 549-8476
NPI assigned
Mar 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Temisan L Etikerentse, MDNPI 1710986757
Title
Ceo MD
Phone
(843) 549-9200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 20234 SC Primary

Addresses

Primary practice location

211 Eddie Chasteen Dr
Walterboro, SC 29488-5728

Mailing address

211 Eddie Chasteen Dr
Walterboro, SC 29488-5728
Phone (843) 549-9200

Other identifiers 1

IdentifierTypeStateIssuer
GP3914MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912967290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 EDDIE CHASTEEN DR",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885728",
            "telephone_number": "843-549-9200",
            "fax_number": "843-549-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 EDDIE CHASTEEN DR",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885728",
            "telephone_number": "843-549-9200",
            "fax_number": "843-549-8476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPECLINIC WALTERBORO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ETIKERENTSE",
        "authorized_official_first_name": "TEMISAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO MD",
        "authorized_official_telephone_number": "843-549-9200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "SC",
            "license": "20234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3914",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walterboro, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.